Two-year follow up of bipolar hemiarthroplasty

Forty-seven bipolar hemiarthroplasties were performed from January 1985 to December 1986. Twenty-three patients (24 hips) returned for a history, physical, and repeat radiographs. Ten primary press-fit and two cemented primary bipolar hemiarthroplasties were performed. Four patients underwent cemented and eight received press-fit revision bipolar hemiarthroplasties. Fourteen patients had simultaneous cancellous, reamed femoral head autograft, or allograft acetabular bone augmentation. Omitting one patient who had replacement for Lévi's pleonosteosis, the average acetabular migration among the remaining 23 patients was 4 mm of superior and 1.5 mm of medial progression. The mean modified d'Aubigne hip score was 33 for primary press-fit arthroplasty, 30 for primary cemented arthroplasty, 22 for press-fit revisions, and 32 for cemented bipolar revision arthroplasty. Morcellized bone graft tended to variably resorb with time. Among the press-fit stems, all but two patients complained of at least occasional thigh pain. All but one patient with primary press-fit hemiarthroplasty walked with a limp. We conclude that, although good early results can be obtained, significant number of patients will have groin and thigh pain. We have found no evidence either radiologically or clinically that nonstructural bone grafting with reamed femoral head will reliably incorporate or prevent further acetabular migration.