Independent, sourced patient educationInformedSurgery
Hip Replacement Explained
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All topics
  1. What it is
  2. Who it helps
  3. Timing
  4. The procedure
  5. What a hemiarthroplasty is
  6. Hemi vs total hip
  7. Recovery after hip fracture
  8. Patient journey
  9. Recovery supplies
  10. Finding a surgeon
  11. Insurance and costs
  12. Questions to ask
  13. Implant designs
  14. Side-by-side
  15. Robotics and navigation
  16. US manufacturers
  17. What the evidence says
  18. Value analysis
  19. Resources
  20. Glossary
  21. References

Hip fracture

Recovery after a hip fracture

Recovering from a broken hip is different from recovering from a planned hip replacement. Most patients are in their 80s, many have other health conditions, and the injury happens without warning. Families play a big part.

The first days

  • Surgery soon. Guidelines support surgery within 24 to 48 hours of arriving at the hospital when the person is medically ready.49 In one large registry analysis, fewer than half of patients were operated on within 48 hours.28
  • Up and moving early. Most teams aim to get the person standing and walking with help as soon as possible after surgery, usually the next day.49
  • Confusion (delirium). Sudden confusion after surgery is common in older adults. In the same registry analysis it was the most frequent complication, affecting about 42%.28 Familiar faces, glasses and hearing aids, a normal day-night routine and avoiding unnecessary sedatives can help. Tell the team if your family member seems more confused than usual.
  • Blood clots. Expect blood thinners and early walking to lower the risk of clots.13

Rehabilitation

Many people go to a rehabilitation unit or skilled nursing facility before going home. The goal is to get back to the level of walking and independence they had before the fall, though not everyone does. One in five patients in the registry analysis died within a year, reflecting how frail many hip fracture patients are.28

Preventing another fracture

  • Ask about a bone density test and treatment for osteoporosis.49
  • Review medicines that cause dizziness or drowsiness.
  • Make the home safer: clear walkways, add grab bars and night lights, and use the walking aid the therapist recommends. See recovery supplies.
Clinical detail
  • Spanish registry meta-analysis (55,680 patients, mean age 84.6, 75% women): 40% operated within 48 hours, delirium 42%, transfusion 36%, mean stay 10.7 days, 1-year mortality 18%.28
  • The AAOS 2021 guideline also supports interdisciplinary care programs and osteoporosis evaluation after fragility fracture.49
Value analysis

Surgical hip and femur fracture treatment is one of the episodes in CMS's mandatory Transforming Episode Accountability Model (TEAM), alongside elective joint replacement.51 Time to surgery, delirium prevention and discharge destination all drive episode cost.

Sources for this page

  1. Salazar CA, et al. Direct factor Xa inhibitors versus low molecular weight heparins or vitamin K antagonists for prevention of venous thromboembolism in elective primary hip or knee replacement or hip fracture repair. Cochrane Database Syst Rev. 2025;1(1):CD011762. doi:10.1002/14651858.CD011762.pub2
  2. Núñez JH, et al. Hip fractures in Spain. How are we? Systematic review and meta-analysis of the published registries. Rev Esp Cir Ortop Traumatol. 2025;69(3):303-317. doi:10.1016/j.recot.2024.09.010
  3. American Academy of Orthopaedic Surgeons. Management of hip fractures in older adults: evidence-based clinical practice guideline (December 3, 2021). aaos.org/hipfxcpg
  4. Centers for Medicare & Medicaid Services. Transforming Episode Accountability Model (TEAM). cms.gov/priorities/innovation/innovation-models/team-model

All references