Question
An 81 year old woman had surgery for a displaced femoral neck fracture.
- What procedure has been done?
- Compare hemiarthroplasty with total hip arthroplasty for this injury.
- What technical points reduce complications?
Answer
Procedure
- Cemented unipolar hemiarthroplasty
Hemiarthroplasty versus THA
| Feature | Hemiarthroplasty | THA |
|---|---|---|
| Patient | Less active, cognitive impairment | Independent, active, cognitively intact |
| Dislocation | Lower | Higher |
| Function | Slightly worse | Slightly better (HEALTH) |
| Acetabular erosion | Possible in active patients | No |
| Operating time | Shorter | Longer |
- Unipolar and bipolar heads give similar results
- Consider dual mobility for THA in frail patients
Technical points
- Cemented stem (NICE, WHiTE 5, AOANJRR data) reduces periprosthetic fracture
- Restore offset and leg length with templating
- Anterolateral approach or posterior with capsular repair
- Careful cementing technique and anaesthetic communication
- Head size matched to the native head
Related pages
Author Contributions
Orthofracs team
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.