Bipolar hemiarthroplasty is a type of partial hip replacement commonly performed in Canada for patients with femoral neck fractures—especially older adults or those with limited mobility before injury.
Unlike total hip replacement, which replaces both the femoral head and the acetabulum (hip socket), bipolar hemiarthroplasty replaces only the femoral head using a specialized implant that allows motion both within the implant itself and within the hip joint.
How It Differs from Unipolar Hemiarthroplasty
- Unipolar hemiarthroplasty: The prosthetic head moves only within the native socket.
- Bipolar hemiarthroplasty: The prosthetic head has an inner bearing between two metal components, reducing friction and potentially decreasing acetabular wear.
This dual articulation makes bipolar prostheses popular in Canada for elderly patients who need reliable, quick restoration of hip function after fracture.
Indications
Bipolar hemiarthroplasty is most often recommended for:
- Displaced femoral neck fractures (especially in elderly patients)
- Non-reconstructible fractures where internal fixation is unlikely to succeed
- Patients with low activity levels who don’t require a full total hip replacement
- Occasionally, tumor or avascular necrosis cases when acetabular integrity is preserved
The Procedure
Surgical Steps
- Incision and exposure – Typically through a posterior or lateral approach.
- Removal of the femoral head – The damaged bone is excised.
- Preparation of the femoral canal – To fit the stem of the prosthesis.
- Insertion of the bipolar prosthesis – The implant includes:
- A metal femoral stem anchored into the thigh bone.
- A modular head with two articulations: an inner bearing and an outer shell.
- Reduction of the hip joint – The new head is placed into the native acetabulum.
- Closure and dressing – Layers of tissue are repaired and the wound is sealed.
The entire surgery usually takes 45–90 minutes, depending on complexity.
Recovery and Rehabilitation
Most Canadian hospitals emphasize early mobilization. Patients often begin standing or walking with assistance within 24–48 hours post-surgery.
Typical Recovery Timeline
- Hospital stay: 3–5 days
- Weight bearing: Often as tolerated, depending on surgical stability
- Physiotherapy: Initiated early to prevent stiffness and complications
- Full recovery: 6–12 weeks for most patients, though long-term function continues improving up to 6 months
Potential Complications
- Dislocation (rare, thanks to bipolar design)
- Infection
- Deep vein thrombosis (DVT)
- Leg length discrepancy
- Loosening of the implant (usually long-term)
Canadian orthopedic centers maintain very low complication rates due to strong infection-control standards and post-operative physiotherapy programs.
Outcomes and Benefits
Numerous Canadian studies report:
- Excellent pain relief
- Rapid return to mobility
- Lower acetabular erosion rates compared to unipolar implants
- Shorter surgery times and less blood loss than total hip replacements
For frail or elderly patients, bipolar hemiarthroplasty provides a balance of safety, stability, and function without the longer recovery of a full arthroplasty.
Cost and Access in Canada
In Canada’s public healthcare system, bipolar hemiarthroplasty is covered by provincial insurance when medically necessary (e.g., after a hip fracture).
Private centers, such as those in Montreal or Calgary, also offer expedited surgery for patients seeking faster access or personalized recovery environments, SurgicalWay can help you to pay less.
Average Wait Times
- Public sector: 2–8 days for acute fractures (priority cases)
- Private centers: Often within 24–48 hours
Living After Bipolar Hemiarthroplasty
After recovery, most patients:
- Walk independently
- Experience minimal or no pain
- Resume light activities such as walking or swimming
- Are advised to avoid extreme hip flexion or impact sports
Periodic follow-up with an orthopedic surgeon ensures implant integrity and joint function for years to come.
Conclusion
Bipolar hemiarthroplasty remains one of the most reliable treatments for displaced femoral neck fractures in Canada.
With advances in implant design, surgical technique, and rehabilitation, patients now enjoy faster recovery, better stability, and longer implant lifespan.
