Conversion of Bipolar Hemiarthroplasty to Total Hip Arthroplasty: Indications, Surgical Challenges and Functional Outcome: A Retrospective study

Background: Bipolar hemiarthroplasty is often used for the treatment of femoral neck fractures, particularly in the elderly. Over time however, adverse events like acetabular erosion, continuing pain and implant failure may require conversion to total hip arthroplasty (THA). The conversion process is technically challenging and comes with a number of surgical issues. The objective is to assess the indications, difficulties encountered and the functional results of conversion of BHA to THA. Material and Methods: This was a retrospective study involving 50 cases of bipolar hemiarthroplasty converted to THA in a tertiary care center at Bhagalpur in 2 years period. Indications, operative findings, complications and functional outcome with Harris Hip Score were recorded and analyzed. Results: Acetabular erosion and persistent pain and implant loosening were the most prevalent indications for conversion. Surgical problems were the removal of the implant, bone loss and long operating time. Functional outcomes and complications were significantly improved after surgery. Conclusion: The conversion of failed hemiarthroplasty into THA is technically challenging yet is an effective procedure. Favorable outcome requires proper patient selection and careful surgical technique. Hemisuspension arthroplasty (HHA) and total hip arthroplasty (THA) are indicated for treatment, with conversion surgery indicated when there is acetabular erosion. Treatment is indicated by performing either a HA or THA, with conversion surgery indicated if there is acetabular erosion.

Keywords: Bipolar Hemiarthroplasty, Total Hip Arthroplasty, Conversion Arthroplasty, Hip Surgery, Functional Outcome, Surgical Challenges.