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Do I Need a Hip Replacement for a Hip Fracture?

March 01, 2023

Every year more than 300,000 people ages 65 and older in the United States are hospitalized for hip fractures.

Most hip fractures occur in the home because of a slip or fall. While surgery is usually necessary for a hip fracture, the type depends on the patient and the extent of the injury.

David Martin, MD, is an orthopedic surgeon with the Connecticut Orthopaedic Institute at St. Vincent’s Medical Center in Bridgeport. St. Vincent’s recently received a Joint Commission certification for hip fracture.

Dr. Martin explains when a patient needs a hip replacement versus hip repair surgery.

Surgery is almost always needed

If you do fracture your hip, it’s unlikely that you’ll be able to walk away without some kind of surgery to repair it.

“On rare occasions, hairline fractures can be treated non-operatively but this would require a prolonged period of immobility or highly protected weight bearing and is associated with substantial pain,” says Dr. Martin.

Surgery allows mobilization, pain relief and ultimately a faster recovery than being left to heal on its own.

Hip repair vs. hip replacement

Surgery for a hip fracture is either repair or replacement. Certain fracture patterns, such as femoral neck, are associated with a disruption of blood flow and poor healing.

“In this circumstance, a replacement is usually recommended,” says Dr. Martin. “Other patterns have better-preserved blood flow and healing potential. These are repaired with orthopedic hardware such as screws, plates, nails and rods.”

The hardware stabilizes the fracture and allows the bone to heal. In both repair and replacement, the patient can walk shortly after surgery.

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Does age play a factor?

While hip fractures usually occur in adults over 65, younger people can fracture their hips from accidents.

For a younger person, more aggressive attempts are made to repair rather than replace the hip.

“A 30-year-old who suffers a displaced femoral neck fracture in a motor vehicle accident would most likely have a repair as opposed to a 70-year-old who may have the same injury in the same accident,” says Dr. Martin.

Prevention is key

The recovery time for a hip fracture can take up to a full year, and most patients do not go back to their pre-fracture function. Most hip fracture patients require a short stay at an extended care or rehabilitation facility.

“Therefore, the best treatment for hip fractures is prevention,” says Dr. Martin.

Dr. Martin recommends:

• Osteoporosis screening and prevention.
• Lifestyle changes such as quitting smoking and limiting alcohol intake
• Screening your home for fall hazards
• Exercise and eat healthy