Hip Replacement Surgery Boosts Fracture Risk in Patients With Osteoarthritis

Fracture risk in patients with hip osteoarthritis (OA) undergoing a total hip replacement (THR) procedure increases by 25% at 2.5 to 5 years postsurgery. Bisphosphonate use reduces fracture risk in patients in whom there was no fracture before surgery and in those who had a previous osteoporotic fracture and received the treatment in secondary prevention.

Prieto-Alhambra and colleagues conducted a population-based parallel-cohorts study of patients in the UK General Practice Research Database undergoing THR for hip OA. Five controls were identified for each case and matched with patients by age, sex, and practice site. Patients were monitored for up to 5 years. Fracture rates and rate ratios were estimated, and bisphosphonate use was identified among patients undergoing THR.

Fracture rates were higher in patients undergoing THR after surgery and significantly higher at years 2.5 to 5 postsurgery. There was a 44% decrease in fracture risk in bisphosphonate users in whom there was no fracture before surgery and a 52% reduction in those with a previous osteoporotic fracture.

The authors noted that because patients who have undergone THR are at increased risk for fracture, they may need to be properly assessed for fracture risk before or at the time of surgery.