Outcomes of Total Hip Arthroplasty and Contralateral Bipolar Hemiarthroplasty

There is continuing controversy about whether total hip arthroplasty or bipolar hemiarthroplasty should be used for the management of displaced subcapital hip fractures or advanced avascular necrosis of the femoral head, especially in patients with normal-appearing acetabular cartilage. The decision regarding which procedure to perform may be influenced by several factors, including the underlying disease process, perioperative risks 1,2, likelihood of revision 3-5, and economic considerations 6-8. Published reports are difficult to interpret because the series differ with regard to the surgeons performing the operations, surgical approaches, methods of fixation, postoperative protocols, patient mix, and duration of follow-up 3,5,9-18. In our retrospective review, we compared the clinical and radiographic results and patient-reported outcomes of the two procedures in nine patients who had undergone a bipolar hemiarthroplasty on one side and a total hip arthroplasty on the other.