This anterior-posterior (AP) pelvic radiograph demonstrates bilateral hip hemiarthroplasty with bipolar prostheses in situ. Each prosthesis consists of a high-density, radiopaque femoral stem inserted into the medullary canal, a femoral neck, and a dual-bearing spherical head component articulating with the native acetabulum. The right hip features a recently implanted modular bipolar hemiarthroplasty, appearing well-aligned without signs of loosening. The left hip shows a long-standing cemented bipolar prosthesis, with visible cement mantle density around the femoral stem. The pelvic bony architecture, including the iliac wings, sacrum, and pubic symphysis, appears intact with age-related coarsening of the trabecular pattern. There is no evidence of periprosthetic fracture, osteolysis, or component migration. Soft tissue shadows show medical tubes and monitors consistent with an immediate postoperative setting. This image serves as a clinical example of surgical management for femoral neck fractures or advanced hip pathology using bilateral arthroplasty techniques.

This diagnostic image is an anteroposterior plain X-ray of the left hip joint demonstrating a serious orthopedic complication following surgery. The image shows a bipolar hemiarthroplasty prosthesis with two distinct abnormalities: dislocation and uncoupling. The femoral stem remains situated within the femoral shaft; however, the bipolar prosthetic head has completely detached (uncoupled) from the femoral neck component. This dissociated prosthetic head is seen lying superior and lateral to the native acetabulum in the supracetabular soft tissues. Visible anatomical structures include the pelvis, the acetabular rim, and the proximal femur. Surgical skin staples are visible along the lateral soft tissue margin, indicating recent operative intervention. This case illustrates a rare failure mode of bipolar hip arthroplasty, where the modular components separate, leading to prosthetic dislocation and loss of joint articulation. It is a critical finding for medical students and residents in orthopedic surgery and emergency medicine.

This composite of four anteroposterior (AP) pelvic radiographs illustrates acute femoral neck fractures and their subsequent management with hip hemiarthroplasty. Panels 'a' and 'c' demonstrate displaced fractures of the right femoral neck. Key features include cortical discontinuity, superior migration and external rotation of the femoral shaft, and disruption of Shenton’s line, indicating a total loss of alignment between the femoral head and the acetabulum. Panels 'b' and 'd' show the postoperative results of different hemiarthroplasty techniques for managing these fractures. Panel 'b' depicts a unipolar monoblock prosthesis (Austin-Moore type) characterized by a solid, single-component femoral stem and head fixed within the femur. Panel 'd' shows a bipolar hemiarthroplasty, featuring a modular femoral stem and a dual-mobility head designed to articulate both with the acetabulum and at a secondary internal joint. These images serve as educational examples for orthopedic radiology, highlighting the classification of intracapsular hip fractures and the selection of prosthetic implants based on patient needs and surgical protocol.

Anteroposterior and lateral radiographs of the left hip and proximal femur demonstrate a periprosthetic femoral fracture (PFF) around an existing bipolar hemiarthroplasty (BHA). The prosthesis consists of a metallic femoral stem and a modular, large-diameter femoral head articulating within the native acetabulum. A transverse, minimally displaced fracture is located mid-stem at the femoral diaphysis, consistent with a Vancouver Type B1 classification. This classification implies that the prosthetic stem remains well-fixed despite the surrounding fracture. The femoral cortex shows signs of thinning, suggesting underlying osteopenia or osteoporosis. No significant comminution, periosteal reaction, or implant subsidence is visible. This imaging is characteristic of geriatric orthopedic trauma involving existing joint replacements, requiring surgical stabilization while preserving the stable implant.