Bipolar arthroplasty in non-infective hip arthritis

Background: Hip arthroplasty is the most commonly performed adult reconstructive hip procedure. Not all the patients have extensive deformities of both the femoral head and acetabulum, for which a dual-assembly total hip prosthesis is required. The bipolar arthroplasty as used today has rather specific indications; but a young patient with an avascular head is considered the best candidate. Method: Thirty five bipolar arthroplasties were performed in 29 patients using Talwalkar′s bipolar prosthesis for non-infective hip arthritis and the patients were evaluated using Harris Hip Score. Twenty four hips in 21 patients (mean age = 36.17 years) could be followed up for inclusion in this study. Results: At an average follow up of 3.5 years, HHS on an average increased by 43.50; from preoperative 39.58 to post-operative 83.08. Good-to-excellent results were obtained in 19 (excellent- 11; good- 8) hips. Anterior thigh pain, hip pain, deep infection, longitudinal split of femoral shaft and death was seen in one case each. Conclusion: We conclude that bipolar arthroplasty is a simple, reliable, viable and a cost-effective; primary surgical treatment modality in non-infective hip arthritis for young to middle aged patients, especially in our scenario where funds for the operative procedure, prosthesis as well as adequate infrastructure for the hospital are, by and large, limited.