Femoral stem dislodgement during bipolar hemiarthroplasty dislocation

Bipolar hemiarthroplasty remains a treatment option for displaced femoral neck fractures in elderly patients without pre-existing hip disease. Implant-related complications associated with this procedure include acetabular erosion, dislocation, disassembly of the modular components, polyethylene debris-induced osteolysis, metallosis from outer cup impingement, and femoral component loosening. This article presents a case of a patient in whom the polished collarless tapered femoral stem dislodged out of the cement mantle during traumatic bipolar hemiarthroplasty dislocation, 28 days after the index procedure. This complication, associated with bipolar hemiarthroplasty dislocation, was adequately managed by driving the stem back to the original cement mantle, followed by reduction of bipolar component dislocation and placing bone cement over the shoulder of the femoral stem to prevent a new dislodgement episode. Although rare, dislodgement of cemented polished collarless tapered stems from the cement mantle has been recently reported either during dislocation or, more frequently, as a complication of reduction of a dislocated total hip arthroplasty. However, its occurrence in association with bipolar hemiarthroplasty dislocation was not found to have been reported in the literature. The occurrence of femoral stem dislodgement during bipolar hemiarthroplasty dislocation should be considered as a possible complication of such a procedure and may be prevented by routinely placing bone cement over the shoulder of the femoral implant.