Introduction
Hip fractures are a frequent and serious problem, especially among older adults. These injuries happen when the upper part of the thigh bone (femur), near the hip joint, breaks — typically due to falls or weakened bones caused by conditions like osteoporosis. For elderly people, a hip fracture is not just painful but can significantly reduce mobility and overall health. Because of these risks, surgery is often necessary to restore movement and improve quality of life.
One common surgical option for hip fractures in older patients is bipolar hip replacement, also called bipolar hemiarthroplasty. This procedure involves replacing the damaged ball part of the hip joint with a specially designed implant that reduces pain and helps movement, while keeping the natural socket intact. Professor Paul Lee, a leading orthopaedic surgeon, together with the expert team at MSK Doctors, provide exemplary care combining advanced surgical skills and compassionate rehabilitation support to help patients recover well.
Understanding Bipolar Hip Replacement
Bipolar hip replacement is a type of partial hip replacement where only the ball (femoral head) is replaced, while the socket (acetabulum) remains natural. This is different from a total hip replacement, which replaces both ball and socket components.
Within partial replacements, there are two main designs: unipolar and bipolar hemiarthroplasty. A unipolar prosthesis uses a single-piece implant that moves directly against the natural socket. In contrast, a bipolar implant has two parts — an inner ball that moves independently within an outer shell — which then moves against the socket. This dual movement can offer smoother motion and may protect the socket from excessive wear.
Research shows that bipolar hip replacements can be very durable. For instance, a recent study found that “bipolar hip replacement is a durable limb-preserving reconstruction that can outlast patients’ lifespans and is well-tolerated by oncology patients” (Singh et al., 2024). The differences between unipolar and bipolar designs, often discussed under terms like “unipolar vs bipolar hemiarthroplasty,” can also be seen clearly on X-rays after surgery. Drawing on his extensive experience, Professor Lee can advise which implant is best suited to individual patient needs.
Who is Suitable for Bipolar Hip Replacement? Procedure and Precautions
Bipolar hemiarthroplasty is usually recommended for elderly patients who have suffered a type of hip fracture called an intracapsular fracture and who may not be able to undergo total hip replacement due to age, bone quality, or other health issues. It works well for those with lower activity levels or multiple health concerns because it balances good function with a lower risk of complications.
Beyond typical trauma cases, bipolar hip replacement is sometimes used for other difficult conditions. For example, patients with avascular necrosis—a loss of blood supply to the bone—due to sickle cell disease have received this treatment with success. As one study noted, this procedure “should be considered in carefully selected patients who have avascular necrosis of the femoral head” (Sanjay & Moreau, 1996).
The surgery involves making an incision near the hip, removing the broken femoral head, and fitting the bipolar implant into the thigh bone. This implant allows the joint to move naturally within the socket, offering more stability than older designs.
When bipolar replacement is done promptly after certain fractures, it can greatly improve outcomes. In fact, research on intertrochanteric hip fractures (a break in a different part of the thigh bone) reported that “if performed shortly after injury, this procedure allows the restoration of correct limb length and almost nullifies the classic complications of osteosynthesis as well as mortality during or after surgery” (Surace et al., 1991).
After surgery, patients need to follow specific precautions—often called “hip precautions”—to reduce risks such as dislocation. These usually include avoiding bending the hip too far, twisting the leg sharply, or crossing the legs. MSK Doctors ensures patients receive clear guidance and personalised support to help keep their recovery safe and effective.
Recovery and What to Expect After Surgery
Recovery from bipolar hip replacement generally takes several weeks to a few months, though this varies depending on individual health and conditions before surgery. Most elderly patients start gentle mobilisation within days, aided by tailored physiotherapy that helps restore strength, flexibility, and confidence while respecting surgical precautions.
When it comes to outcomes, bipolar implants often outperform unipolar ones by reducing wear on the hip socket and offering better joint movement. For example, a study in patients treated for orthopaedic cancers found “the incidence of acetabular erosion and revision surgery is low. Despite radiological evidence of hip degeneration, functional status in patients is not significantly impacted” (Singh et al., 2024). Meanwhile, in sickle cell disease patients, the average hip function score improved dramatically post-surgery, though this group had a higher rate of complications (Sanjay & Moreau, 1996).
Compared with total hip replacement, bipolar hemiarthroplasty usually means a shorter operation with fewer immediate risks, but it might not provide quite the same long-term function for highly active patients.
Cost can also be a factor. The “bipolar hip replacement cost” varies depending on whether care is provided through the NHS or privately. MSK Doctors offer transparent information to help patients and families understand their options.
The Role of Skilled Care and Final Thoughts
The success of bipolar hip replacement relies heavily on the expertise of the surgical and rehabilitation team. Skilled specialists like Professor Paul Lee and the MSK Doctors team combine surgical precision with attentive care to deliver the best possible outcomes for elderly patients.
In summary, bipolar hip replacement is an effective treatment option for hip fractures in older adults. It offers improved joint stability and a good recovery outlook while reducing surgical risks. Careful selection of patients, strict adherence to post-surgery precautions, and properly guided rehabilitation are key to achieving the best results.
For personalised medical advice tailored to your situation, it is important to consult a qualified healthcare professional.
References
Sanjay, B. K. S., & Moreau, P. G. (1996). Bipolar hip replacement in sickle cell disease. International Orthopaedics, 20(4), 222-226. https://doi.org/10.1007/s002640050068
Singh, V. A., Ooi, Y. J., Santharalinggam, R. D., & Yasin, N. F. (2024). The status of acetabulum in bipolar HIP replacements in orthopaedics oncology cases. Journal of Orthopaedic Surgery, 32(3). https://doi.org/10.1177/10225536241306917
Surace, A., Mineo, G., Micale, C., & Previtera, A. M. (1991). Bipolar prosthetic replacement for the management of intertrochanteric hip fractures. Hip International, 1(3), 153-156. https://doi.org/10.1177/112070009100100307
Frequently Asked Questions
Professor Paul Lee is a cartilage expert and recognised Regional Surgical Ambassador. His extensive experience as a Royal College of Surgeons of Edinburgh Advisor allows MSK Doctors to deliver high-standard, individualised care for hip fractures and complex joint injuries.
MSK Doctors, led by Professor Lee, use advanced techniques in bipolar hip replacement. This approach reduces pain, improves joint motion, and helps restore independence, with the added benefit of careful rehabilitation planning to ensure each patient achieves the best possible functional recovery.
A bipolar hip replacement, offered at MSK Doctors, uses a two-part implant that moves more smoothly within the hip socket. This design may help reduce wear on the joint compared to unipolar prostheses, offering better comfort and longer-term protection, especially for less active patients.
Bipolar hemiarthroplasty is usually recommended for elderly patients with intracapsular hip fractures, especially those unable to undergo total hip replacement due to age or other health concerns. Professor Lee’s experience ensures careful patient selection and individualised recommendations at MSK Doctors.
MSK Doctors provide comprehensive guidance, including tailored physiotherapy and clear post-surgery precautions. Professor Lee’s expertise ensures patients are well-supported, enabling a safe and effective recovery focused on improving strength, mobility, and confidence after surgery.