What is Hemiarthroplasty?

Hemiarthroplasty is a surgical technique used to replace a part of a joint with an artificial implant. It is usually performed in case of a hip fracture, or a degenerative condition like shoulder arthritis. A hemiarthroplasty can help restore movement and preclude health complications that can result from prolonged immobilization. Generally, the patient is required to stay in the hospital for a few days after undergoing the surgery, and physical therapy is usually recommended as a follow-up treatment.

The ball and socket joint of the hip links the top of the thigh bone — the femur — to the pelvis. A hip fracture may involve the neck of the femur, which is the part of the bone near the ball of the joint. Injury to this area can impair the blood supply to the top of the thigh bone, so the fracture may not heal well; such a fracture could cause the bone to die and cave in. This type of hip fracture is often treated with a hemiarthroplasty, in which a prosthetic device is placed in one half of the hip joint.

A hemiarthroplasty could also help treat a shoulder fracture. Sometimes this surgical procedure is performed on patients who suffer from arthritis of the shoulder, the joint that lies at the junction of the upper arm bone and the shoulder blade. In such cases, the arthritic joint can be partially replaced. A metal ball could be implanted at the top of the upper arm bone to help the shoulder function better.

The surgeon may use general or regional anesthesia to carry out a hemiarthroplasty. Customarily, the procedure involves accessing the joint and implanting the prosthesis. When the socket is in good condition, only the ball part of the joint is replaced with a prosthetic device. Usually, the prosthetic device is comprised of a metal stem and ball; the metallic ball goes into the socket of the joint.

The surgeon may use a form of cement to bond the prosthesis to the bone. Alternatively, the surgeon might prefer a prosthesis which has fine holes on the surface; the patient's own bone grows through the mesh, and binds the implant.

The patient may be kept in the hospital for three to seven days after the surgery. Typically, the patient is provided pain relief for discomfort that may be experienced. Normally, a physical therapist helps the patient move about in the days following the surgery. A walking aid may be needed for a few weeks after a hip hemiarthroplasty. Usually, the patient is recommended precautions to take when performing daily activities to avoid stress on the joint and prevent dislocation.

Generally, physical therapy continues after the patient leaves the hospital, and might be conducted at a rehabilitation facility. The physical therapist could recommend various exercises to enhance mobility, improve range of motion, and enable the patient to return to normal activities.