Which statement best describes differences in indications and outcomes between hemiarthroplasty and total hip arthroplasty?

• A. Hemiarthroplasty replaces femoral head only; total replaces both; total generally better pain relief and function but higher dislocation risk
• B. Hemiarthroplasty replaces both
• C. Total hip arthroplasty is always superior
• D. Hemiarthroplasty has higher dislocation risk

Answer: (A)

Replacing only the femoral head vs replacing both surfaces changes both why the procedures are chosen and how patients tend to do afterward. In hemiarthroplasty, the operation swaps out just the femoral head and leaves the acetabular socket as is. This makes the procedure simpler, often with shorter operation time and less blood loss, and it’s a common choice for isolated femoral neck fractures in frail, older patients or when the acetabulum isn’t arthritic. But over time the native acetabular cartilage can wear against the prosthetic head, which may cause new pain and sometimes require a future conversion to a total hip.

Total hip arthroplasty replaces both the femoral head and the acetabular socket, creating a new, smooth joint surface. This tends to provide superior pain relief and better function, especially in hips with established arthritis, AVN, or when the acetabulum is involved. The trade-off is a more extensive surgery with higher risk of dislocation and other complications.

So, the statement that total hip arthroplasty generally offers better pain relief and function but carries a higher dislocation risk best reflects the typical differences in indications and outcomes between the two procedures.