Hemiarthroplasty is a surgical procedure that involves the partial replacement of a joint, commonly in the hip or shoulder. The term Hemiarthroplasty is a partial joint replacement where the prefix “hem-” is a Greek word meaning ‘half’ and the suffix “-plasty” is derived from the Greek word “plassein” which means ‘to shape or mould’.

Hip Hemiarthroplasty

Hemiarthroplasty in the hip is a procedure in which only the femoral head (the “ball” of the ball-and-socket joint) is replaced with a prosthesis while the acetabulum (the “socket”) is not replaced. This type of surgery is often done when the hip bone is broken and the patient is elderly as their bones may be too weak for other surgeries. It is often advised when there is poor blood flow to the femoral head, such as in a displaced femoral neck fracture, and when a total hip replacement may be considered too aggressive.

Shoulder Hemiarthroplasty

In the shoulder, hemiarthroplasty entails the replacement of the humeral head (the ball) with a prosthetic component while preserving the glenoid (the socket). This is often done in cases of severe arthritis or fractures of the humeral head that cannot be fixed. It is used when the glenoid is stable and does not require replacement.

Indications

·        Hip Hemiarthroplasty: Usually used in cases of femoral neck fractures, avascular necrosis, or specific types of hip arthritis that affect only the femoral head.

·        Shoulder Hemiarthroplasty: Commonly applied in cases of multiple fractures of the head of the humerus, some types of arthritis of the shoulder joint or when the patient’s glenoid is healthy.

Procedure

·        Hip Hemiarthroplasty: The surgery is done by making an incision over the hip joint; the damaged femoral head is then removed and replaced with a metal or ceramic prosthesis. The prosthetic femoral head is then inserted into the acetabulum.

·        Shoulder Hemiarthroplasty: This surgery involves making an incision over the shoulder; the damaged humeral head is then removed and replaced with a prosthetic. The remaining portions of the joint are typically left alone unless there is evidence of other injury that requires treatment.

Recovery

The recovery process after hemiarthroplasty may take some time, and the patient may need to undergo physiotherapy to strengthen the joint. The time it takes for a patient to recover and rehabilitate may vary depending on some factors such as the patient’s health status, his or her age, and other illnesses that the patient may have.

Risks and Complications

Like any surgery, hemiarthroplasty also has risks such as infection, blood clots, dislocation of the prosthesis, and wear and tear or loosening of the prosthesis. It is also possible that there will be a discrepancy in the length of the legs (in the case of hip hemiarthroplasty) or limited motion (in the case of shoulder hemiarthroplasty).

In summary, hemiarthroplasty is a proven procedure that offers considerable pain relief and functional gain to patients with specific joint pathology.