Hemiarthroplasty is a surgical procedure for half-joint replacement; hemi refers to "half". This procedure is recommended in case of hip fractures and sometimes even to treat arthritis of the hip, where there is significant damage to the hip.
The hip joint is a ball-in-socket joint of the head of the femur (thighbone) and the socket of the acetabulum (hip).
Hemiarthroplasty is a procedure where the femoral head needs replacement and is replaced. It is different from total hip replacement where the femoral head and the socket both need replacement.
Hemiarthroplasty is a preferred procedure when the acetabulum is intact, whether fracture or arthritis.
Hemiarthroplasty when performed for an arthritic hip, there can be some preparation or planning.
However, in the case of a fracture due to a fall or any other form of injury, the procedure needs to be done immediately.
The patient needs to be mentally prepared for a stay at the hospital for a few days post-surgery before discharge.
The doctor in consultation with the patient decides the anesthesia. It can be general anesthesia, whereby the patient is asleep during the procedure.
Alternatively, an epidural (regional anesthesia). Here the patient is awake, only the body from hip down is numb.
Once the anesthesia takes effect, the doctor makes an incision near the hip, on the side of the thigh.
Once the ball-in-socket joint can be seen, the surgeon detaches the ball of the femur, by releasing it from the tendons, ligaments, and muscles, which keep it in position in the socket.
It is also separated from the femur. Once removed, a metal stem is fit into the hollowed femur, such that it fits securely and comfortably.
An artificial metallic femur head is attached atop the stem. This could be further attached to an additional head that is lined with plastic (polyethylene). This is referred to as bipolar prosthesis (head-within-head).
The prosthetic head is positioned back in the socket and the incision sutured and bandaged. The surgeon may decide to place a drain to empty whatever little bleeding that may occur.
The patient needs to stay at the hospital for a few days after the procedure.
The doctor prescribes pain medications and while at the hospital, the physical therapy for recovery is started for the patient.
The physical therapy will continue even after the patient has been discharged and is at home.
There will be regular visits to monitor the progress and mobility of the joint after the surgery and the overall well-being of the patient.
After the surgery, the patient needs to reduce or preferably avoid activities that involve heavy weight lifting or climbing.
Engagement in sports should also be reduced. Light exercises for fitness can be a part of the daily routine.
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