Hip Fracture Surgery Vs. Total Hip Replacement: The Risks

Hip fracture surgery may be riskier than total hip replacement

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Like all surgery, hip surgery has its risks. But there may be some important differences between hip fracture and total hip replacement (THR) surgeries.

A new study from Canada that compared patients who needed surgery for a fractured hip with patients who elected to undergo THR found that patients with hip fractures tended to be older. They also tended to have other medical conditions, and be at a higher risk of complications and death.

When a patient breaks a hip, surgery is usually needed to help the fracture heal. In a THR, the damaged bone is removed and the hip joint is replaced by a prosthesis.

Past research has found that patients who underwent hip fracture surgery were more likely to have complications than those who underwent a THR. The reasons for this difference are still largely unknown.

Yannick Le Manach, MD, PhD, an anesthesiologist and assistant professor at McMaster University in Ontario, led this study of more than 690,000 patients.

Dr. Le Manach and team used the French National Hospital Discharge Database to look at patients who had these surgeries between January 2010 and December 2013. All patients were at least 45 years old.

Patients who had a THR were generally younger and healthier than patients who had hip fracture surgery.

The risk of death for patients who had fracture surgery was 1.8 percent, while the risk of death for THR patients was only 0.3 percent.

Similarly, patients who had fracture surgery had a 5.9 percent risk of major complications — compared to 2.3 percent for THR patients. Fracture patients were also more likely to be admitted to the intensive care unit and to stay longer in the hospital.

According to Dr. Le Manach and team, a hip fracture may cause trauma, pain, bleeding and immobility. These factors may also increase the risk of complications, such as heart attack, pneumonia and stroke.

Performing the operation as quickly as possible after the injury can help minimize potential complications.

This study was published Sept. 15 in the journal JAMA.

Hamilton Anesthesia Associates, the CANadian Network and Centre for Trials INternationally, the United Kingdom Medical Research Council and the Heart and Stroke Foundation of Ontario funded this research.

Several study authors disclosed funding from companies that make drugs or products used in the care of surgical patients.

Review Date: 
September 11, 2015
Last Updated:
September 18, 2015