What Is Hemiarthroplasty Of The Hip?
Hemiarthroplasty is a surgery most commonly done for fixing a hip fracture. A Hemiarthroplasty is a procedure that is quite similar to a total hip replacement but this procedure involves only half of the hip meaning that only half the joint is replaced during a Hemiarthroplasty.
Hemiarthroplasty changes just the ball portion of the hip joint and not the socket portion of the hip. Anatomically speaking, the hip joint is a ball and socket joint where the ball is the femur and the socket is formed by the acetabulum. The ball fits into the socket and allows the hip joint to move.
The blood supply to the femoral head comes from the femoral neck which connects the ball of the hip joint to the main shaft of the bone. If for any reason there is damage to any nerve or vessel which results in decreased supply of blood to the hip joint then it may result in various complications. It can cause the hip bone to become necrosed. Another complication of a hip fracture is development of a condition called avascular necrosis in which the hip bone collapses causing pain in the hip.
Thus a fracture of the hip is something that needs to be corrected and fixed as soon as possible to prevent potentially serious complications and this can be done best with a Hemiarthroplasty.
What Are The Advantages Of Hemiarthroplasty Of The Hip?
The majority of the fractures of the hip involve the femoral neck. In many cases of hip fractures, the risk of developing an avascular necrosis is so high that the surgeon defers fixing the fracture and instead prefers replacing the femoral head with prosthesis. This is because fixing the fracture will anyways require a reoperation few months down the line due to necrosis of the femoral head as a result of avascular necrosis.
In most of the cases, when a hip is fractured the acetabulum is normally not affected. If the articular cartilage surrounding the acetabulum is in a good condition then a hemiarthroplasty can be done which will allow the ball to glide smoothly over the socket. This is a much better option than replacing the entire hip and also it allow the patient to be up and around with very less recuperating time after surgery. A hemiarthroplasty also helps prevent more serious complications that may arise out of a total hip replacement. This is especially true in the elderly population who are prone to hip fractures due to frequent falls as a result of their age and other underlying medical conditions. In such cases, a hemiarthroplasty can get the patient out of bed in the fastest possible time and reduce the risk of any complications.
Procedure: How Is Hemiarthroplasty Of The Hip Done?
In order to do a Hip Hemiarthroplasty, the surgeon will first make an incision on the side of the thigh to gain access to the hip joint. This can be done through various approaches and different surgeons use different approaches for making an incision.
Upon entering the hip joint, the surgeon removes the femoral head from the acetabulum. Special rasps are used to shape the hollow femur to get the exact shape of the metal stem of the prosthesis. Once the surgeon is satisfied with the size and shape of the stem, it is then inserted into the femoral canal. When an uncemented variety of femoral component is used, the stem is held in position just by the tightness with which the stem fits into the bone. While in the cemented variety, the femoral canal is enlarged to a size which is a bit larger than the femoral stem and cement is used to fix the metal stem to the bone.
The metal ball making up the femoral head is then attached. Once the implant is fixed in placed, the new hip is reduced and placed back into its normal; anatomical position. The surgeon then moves the hip making sure that it moves well before closing the incision. The patient is then sent to the recovery room when he or she is observed for any complications that may arise. If none arises, then the patient is discharged with a week from the hospital and is free to carry out normal activities of daily living albeit a bit carefully after a Hip Hemiarthroplasty.
What Are The Potential Complications Of A Hemiarthroplasty Of The Hip?
As is the case with any major surgery, there is always a potential for complications. Some of the complications inherent with a Hip hemiarthroplasty are infection, loosening of the implant, implant failure, implant breakage, dislocation, worsening of pain, and other medical and anesthetic complications adherent to a hip Hemiarthroplasty.
