A Rare Complication of Intraprosthetic Dissociation of Cemented Bipolar Hemiarthroplasty during Closed Hip Reduction: Case Report and Literature Review

Abstract

Hip hemiarthroplasty (HA) remains a frequently performed surgery for femoral neck fractures especially in the oldest, lowest demand patients. Debate persists concerning the optimal choice between unipolar and bipolar HA implants. A rare but important to recognize complication unique to bipolar HA is intraprosthetic dissociation (IPD). We review the literature on this rare phenomenon and identify predominant etiologies and implant components most involved in IPD, notably the role of hip dislocation and closed reduction in precipitating this complication. We also describe an elderly male patient with Parkinson's who experienced IPD of his bipolar HA during a closed reduction attempt. IPD typically requires open reduction and possibly revision of components, adding increased risk of reoperation/revision to those already frail and vulnerable to surgical complications.