This is going out of fashion due to the added complication of osteolysis. The large prosthetic head can be removed and a smaller one attached to the femoral stem and an acetabular cup prosthesis is inserted. The prosthesis may be a bipolar hemiarthroplasty, which can be converted to a total hip arthroplasty in the future. grade 3: marked joint space narrowing, small osteophytes, some sclerosis. grade 2: definite joint space narrowing, defined osteophytes and some sclerosis, especially in the acetabular region. grade 1: possible joint space narrowing and subtle osteophytes. Cemented hemiarthroplasty have fewer prosthesis-related complications when compared to an uncemented hip prosthesis despite similar rates of mortality 4. Different grading schemes are described for plain radiographs of the hip: grade 0: normal. Many organizations worldwide recommend the cemented technique as standard 2,3. When cemented, a plastic medullary cavity plug may be used to stop the inferior migration of the cement. The femoral stem is inserted similarly to total hip arthroplasty and can be cemented or non-cemented. Posterior (Moore, Southern, and true posterior)Īnterior (direct anterior, Smith-Peterson) Hemiarthroplasty is generally performed via one of the following approaches 4: In younger or more active patients, outcomes are better with total hip arthroplasty 1. As the procedure is quicker and far less morbid than internal fixation, hemiarthroplasty is also routinely used in older, less active and co-morbid patients who would not be good surgical candidates for total arthroplasty. Hemiarthroplasty is indicated for the surgical treatment of subcapital neck fractures that are displaced and at high risk of femoral head avascular necrosis, ( Garden III and IV fractures) if treated with DHS internal fixation 1.
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