Unipolar versus Bipolar Arthroplasty

Summary: Hemiarthroplasty is a common procedure in the treatment of femoral neck fractures in the elderly. The decision to perform hemiarthroplasty using a unipolar or bipolar prosthesis remains controversial, with proponents on either side. Advantages of the unipolar prosthesis include lower cost and no risk of polyethylene wear debris. Proposed advantages of the bipolar prosthesis include less acetabular wear and potentially less hip/groin pain. Factors that could play a role in decision-making include patient age, activity level, and associated medical conditions. This article discusses the use of both unipolar and bipolar prostheses for treatment of femoral neck fractures in elderly individuals, with focus on more recent clinical trials.