A partial hip replacement replaces only half of the hip joint. The hip is a ball-and-socket joint, and in this surgery the surgeon replaces just the worn or broken ball at the top of the thigh bone. This leaves the natural socket in place.
A total hip replacement, by contrast, replaces both the ball and the socket. These days, partial replacement is done for a fairly small, specific group of people. It’s most often used for older adults who have broken the upper part of the thigh bone and whose socket is still healthy.
Because it’s a shorter, less risky operation than a total hip replacement, it can be a safer choice for frail patients. This page explains who it’s for, how it works, and why a total hip replacement is usually preferred for most other people.
What condition does this treat:
This is mainly used for two situations:
- A broken neck portion of the femur bone (the bony “bridge” just below the ball). This bridge also carries the blood supply to the ball. When it breaks, that blood supply can be cut off, and the ball can essentially die from lack of blood. If that happens, and if the socket isn’t arthritic, replacing just the ball portion of the femur makes sense. This is the main reason partial replacement is still done, and it’s considered the standard treatment for this type of fracture in older adults.
- Older patients with limited mobility and other health conditions, for whom a shorter, less stressful operation is safer.
It is generally not recommended for hip arthritis or for active people. If there is significant arthritis on the socket side of the joint, then this procedure is not ideal.
When should you consider surgery:
For the patients with a fracture of the neck portion of the femur, this surgery is done 99.9% of the time. A displaced fracture like this won’t heal on its own and leaves the person unable to walk or bear weight.
The more important question is usually which surgery, a partial replacement or a total hip replacement. Partial replacement tends to be chosen when the patient is older, less active, has other health problems that make a longer operation risky.
They also need to have a non arthritic healthy socket portion of the hip. A younger or more active person, or someone with an arthritic socket, is usually better served by a total hip replacement.
What happens during surgery:
You’ll be either fully asleep or numbed from the waist down. The surgeon usually reaches the hip from the front or back (and may use robotic or minimally invasive methods). Then they:
- Remove the damaged or broken ball at the top of the thigh bone.
- Leave the socket alone. Unlike a total replacement, the socket isn’t reshaped or replaced.
- Prepare the hollow space inside the thigh bone using shaping tools, paying close attention to the angle.
- Insert a metal stem (held by a snug press-fit or with bone cement) and attach a new ball on top.
- Fit the new ball into your natural socket, check that it’s stable and moves well and that your leg lengths are even, and close up.
Most of these surgeries use a bipolar design, which is a clever “ball-within-a-ball”: a smaller metal ball rotates inside a larger one, with a smooth plastic layer between them. This gives the joint more stability and movement and helps protect your natural socket. (An older unipolar design, which is just a single fixed ball, is rarely used now.)
The whole operation typically takes about an hour, and is shorter than a total replacement.
Partial unipolar hip replacement X -ray
What does recovery look like:
Recovery tends to be quicker than a total hip replacement, mostly because the operation itself is shorter and involves less blood loss. However, in the setting of fracture, trauma to the soft tissue may slow progress slightly.
Most people are up and walking with support the day after surgery. Because many of these patients are older and less mobile to begin with, the focus is on getting them moving safely as soon as possible. Outside of this, recovery is similar to a total hip replacement.
What are the major risks and complications:
Partial replacement carries the general risks of any hip surgery , such as infection, blood clots, dislocation, and bleeding among them. One risk worth understanding is specific to this procedure over the long term.
The artificial ball rubs directly against your natural socket cartilage. This cartilage can slowly wear down, causing increasing pain over time. This is why partial replacement isn’t a good choice for active young patients.
The more you move, the faster that wear happens. For the older, less active patients this trade-off is usually acceptable. Your surgeon will go over how the risks apply to your situation.
What if you don’t have surgery:
In the setting of a fracture of the neck portion of the femur, treating this non-operatively is not recommended. A displaced fracture like this generally won’t heal on its own, so the person is left in pain and unable to walk.
Staying immobile is especially dangerous for older adults, who can develop serious complications from being unable to move. So while surgery is always a personal decision made with your doctor, surgery is strongly recommended for these fractures. For hip arthritis, the decision is different.
Partial replacement isn’t recommended, so the real choice there is between non-surgical care and a total hip replacement. Your surgeon can help you weigh the options based on your specific situation.
Insurance & Cost
We work with Medicare, most commercial insurance carriers (Aetna, Anthem BCBS, Cigna, Empire BCBS, UnitedHealthcare), and most workers’ compensation and no-fault insurance carriers. Coverage for first ray amputation depends on your specific plan and the medical necessity criteria that apply to your case. Call our billing team at (631) 981-2663 before scheduling to verify your coverage and discuss expected out-of-pocket costs.
For the full list of carriers we accept and patient billing protections, see our Insurance Information page.
For Total Hip Replacement procedure and cost information, please click here.
Do you have more questions?
How does the risk of post-operative complications differ between partial hip replacement and total hip replacement?
Partial hip replacement may be associated with a lower risk of certain post-operative complications such as dislocation and nerve injury compared to total hip replacement, as the surgery involves preserving more of the native hip anatomy and soft tissues. However, the overall risk of complications depends on various factors including patient-specific factors and surgical technique.
Are there any restrictions on driving or returning to work after partial hip replacement surgery?
Patients are typically advised to refrain from driving for a 3-6 weeks after partial hip replacement surgery until they are no longer taking narcotic pain medications and have regained sufficient mobility and strength. Returning to work will depend on the patient’s occupation and the type of activities involved, with most individuals able to resume sedentary or light-duty work within a 2-4weeks to months after surgery.
How does the risk of periprosthetic fracture differ between partial hip replacement and total hip replacement?
Partial hip replacement may be associated with a lower risk of periprosthetic fracture compared to total hip replacement, as the surgery involves preserving more of the native hip anatomy and bone stock. However, certain patient factors such as osteoporosis and implant-related factors can influence the risk of periprosthetic fracture in both procedures.
Can partial hip replacement be performed using computer-assisted navigation techniques?
Yes, partial hip replacement surgery can be performed using computer-assisted navigation techniques, which offer potential benefits such as improved accuracy in implant placement, enhanced surgical precision, and better patient outcomes. Computer-assisted navigation may be particularly useful in complex cases or for achieving optimal component alignment.
How does the risk of post-operative stiffness differ between partial hip replacement and total hip replacement?
Partial hip replacement may be associated with a lower risk of post-operative stiffness compared to total hip replacement, as the surgery involves preserving more of the native hip anatomy and soft tissues. However, individual patient factors and surgical technique can influence the risk of stiffness in both procedures.
How does the choice between partial hip replacement and total hip replacement affect the risk of future revision surgery?
The choice between partial hip replacement and total hip replacement may impact the risk of future revision surgery, as partial hip replacement preserves more of the native hip anatomy and bone stock. However, factors such as implant wear, progression of arthritis, and patient-specific factors can influence the need for revision surgery over time.
Are there specific exercises or physical therapy regimens recommended after partial hip replacement surgery?
Yes, patients typically undergo physical therapy after partial hip replacement surgery to improve hip strength, flexibility, and range of motion. Specific exercises may include gentle stretching, strengthening exercises, and mobility exercises tailored to the individual’s needs and limitations.
How does the risk of infection compare between partial hip replacement and total hip replacement?
Both partial and total hip replacement surgeries carry a risk of infection, but the risk may be slightly lower with partial hip replacement due to the smaller incision size and less extensive surgical exposure. However, infection risk can be minimized through strict adherence to sterile surgical techniques and antibiotic prophylaxis.
What factors influence the choice between a cemented or uncemented prosthesis in partial hip replacement surgery?
Factors such as patient age, bone quality, surgeon preference, and implant design may influence the decision to use a cemented or uncemented prosthesis in partial hip replacement surgery. Cemented prostheses provide immediate fixation, while uncemented prostheses rely on bone ingrowth for stability.
How does the risk of leg length discrepancy differ between partial hip replacement and total hip replacement?
Partial hip replacement may carry a lower risk of leg length discrepancy compared to total hip replacement, as the surgery involves replacing only the damaged portion of the femoral head rather than altering the entire hip joint anatomy. However, careful pre-operative planning and surgical technique are essential to minimize this risk.
Are there specific dietary recommendations or supplements recommended after partial hip replacement surgery?
While there are no specific dietary restrictions following partial hip replacement surgery, maintaining a balanced diet rich in nutrients such as calcium and vitamin D can support bone health and facilitate the healing process. In some cases, healthcare providers may recommend calcium or vitamin D supplements to aid in bone healing.
How does the risk of implant wear and osteolysis compare between partial hip replacement and total hip replacement?
Partial hip replacement may be associated with a lower risk of implant wear and osteolysis compared to total hip replacement, as the surgery involves preserving more of the native hip anatomy and bone stock. However, long-term follow-up and monitoring are essential to detect any signs of implant-related complications.
Can partial hip replacement be performed using minimally invasive muscle-sparing techniques?
Yes, partial hip replacement can be performed using minimally invasive muscle-sparing techniques, which aim to minimize soft tissue damage, reduce post-operative pain, and accelerate recovery. These techniques typically involve smaller incisions and less disruption to surrounding muscles and tendons.
How does the risk of blood loss and the need for transfusion differ between partial hip replacement and total hip replacement?
Partial hip replacement may be associated with a lower risk of blood loss and the need for transfusion compared to total hip replacement, as the surgery involves a smaller incision and less extensive soft tissue dissection. However, individual patient factors and surgical techniques can influence blood loss and transfusion requirements.
Can partial hip replacement be performed as an outpatient procedure?
Yes, partial hip replacement surgery can be performed as an outpatient procedure in select patients who meet certain criteria, such as good overall health, minimal medical comorbidities, and a supportive home environment. Outpatient partial hip replacement allows patients to return home on the same day as surgery and may offer potential benefits such as reduced hospital costs and quicker recovery.
How does the risk of post-operative complications differ between partial hip replacement and total hip replacement?
Partial hip replacement may be associated with a lower risk of certain post-operative complications such as dislocation and nerve injury compared to total hip replacement, as the surgery involves preserving more of the native hip anatomy and soft tissues. However, the overall risk of complications depends on various factors including patient-specific factors and surgical technique.
How does the risk of periprosthetic fracture differ between partial hip replacement and total hip replacement?
Partial hip replacement may be associated with a lower risk of periprosthetic fracture compared to total hip replacement, as the surgery involves preserving more of the native hip anatomy and bone stock. However, certain patient factors such as osteoporosis and implant-related factors can influence the risk of periprosthetic fracture in both procedures.
