Hip fracture surgery: the importance of evidence‐based practice

Peter FM Choong
Med J Aust 2022; 216 (8): . || doi: 10.5694/mja2.51493
Published online: 2 May 2022

Registries are invaluable assets that not only benefit medical research, but also health care for all

During 2015–16, almost 18 700 hip fractures were recorded in Australia; the incidence rate was nearly 200 times as high among people aged 45 years or more than among younger people, and 1.7 times as high for women as men.1 As longevity increases and the prevalence of osteoporosis, sarcopaenia, obesity, and dementia rise in Western countries,2 the numbers of people at risk of fractures will continue to climb.

  • 1 University of Melbourne, Melbourne, VIC
  • 2 St Vincent's Hospital, Melbourne, VIC



I am supported by a National Health and Medical Research Council Practitioner Fellowship.

Competing interests:

I have received consultancy fees and support for travel to designer surgeon meetings related to tumour prostheses from Stryker and Johnson & Johnson.

  • 1. Australian Institute of Health and Welfare. Hip fracture incidence and hospitalisations in Australia (Cat. no. PHE 226). Canberra: AIHW, 2018.‐0816‐44c6‐bdce‐b56e10fd6c0f/aihw‐phe‐226.pdf.aspx?inline=true (viewed Mar 2022).
  • 2. Gandham A, Zengin A, Bonham MP, et al. Incidence and predictors of fractures in older adults with and without obesity defined by body mass index versus body fat percentage. Bone 2020; 140: 115546.
  • 3. Australian Institute for Health and Welfare. Hospitals at a glance 2017–18. Updated 23 Aug 2019.‐at‐a‐glance‐2017‐18/contents/surgery‐in‐australias‐hospitals (viewed Mar 2022).
  • 4. van Staa TP, Dennison EM, Leufkens HG, Cooper C. Epidemiology of fractures in England and Wales. Bone 2001; 29: 517‐522.
  • 5. Pasco JA, Sanders KM, Hoekstra FM, et al. The human cost of fracture. Osteoporos Int 2005; 16: 2046‐2052.
  • 6. Lystad RP, Cameron CM, Mitchell RJ. Mortality risk among older Australians hospitalised with hip fracture: a population‐based matched cohort study. Arch Osteoporos 2017; 12: 67.
  • 7. Turesson E, Ivarsson K, Thorngren KG, Hommel A. The impact of care process development and comorbidity on time to surgery, mortality rate and functional outcome for hip fracture patients: a retrospective analysis over 19 years with data from the Swedish National Registry for hip fracture patients, RIKSHÖFT. BMC Musculoskelet Disord 2019; 20: 616.
  • 8. Johansen A, Golding D, Brent L, et al. Using national hip fracture registries and audit databases to develop an international perspective. Injury 2017; 48: 2174‐2179.
  • 9. Sambrook PN, Seeman E, Phillips SR, Ebeling PR. Preventing osteoporosis: outcomes of the Australian Fracture Prevention Summit. Med J Aust 2002; 176 (8 Suppl): S1‐S16.‐osteoporosis‐outcomes‐australian‐fracture‐prevention‐summit
  • 10. Tan AC, Armstrong E, Close J, Harris IA. Data quality audit of a clinical quality registry: a generic framework and case study of the Australian and New Zealand Hip Fracture Registry. BMJ Open Qual 2019; 8: e000490.
  • 11. Harvey L, Harris IA, Mitchell RJ, et al. Improved survival rates after hip fracture surgery in New South Wales, 2011–2018. Med J Aust 2022; 216: 420‐421.
  • 12. Australian and New Zealand Hip Fracture Registry Steering Group. Australian and New Zealand guideline for hip fracture care: improving outcomes in hip fracture management of adults. Sept 2014.‐content/uploads/sites/1164/2021/12/ANZ‐Guideline‐for‐Hip‐Fracture‐Care.pdf (viewed Mar 2022).
  • 13. Baroni M, Serra R, Boccardi V, et al. The orthogeriatric comanagement improves clinical outcomes of hip fracture in older adults. Osteoporos Int 2019; 30: 907‐916.
  • 14. Porter ME. Value‐based health care delivery. Ann Surg 2008; 248: 503‐509.
  • 15. Australian Orthopaedic Association National Joint Replacement Registry. 2019 Annual Report: hip, knee, shoulder arthroplasty, September 1999 – December 2018. 2019.‐22df‐a3bb‐37a2‐91e6c00bfcf0 (viewed Mar 2022).
  • 16. de Steiger RN, Hang JR, Miller LN, et al. Five‐year results of the ASR XL Acetabular System and the ASR hip resurfacing system: an analysis from the Australian Orthopaedic Association National Joint Replacement Registry. J Bone Joint Surg Am 2011; 93: 2287‐2293.


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