Study Helps Forecast Recovery Time, Return to Activities After Hip Fracture Surgery

There are many unknowns about the recovery from hip fracture surgery. Mobility is a concern, along with a return to pre-fracture level of function.

Perhaps the greatest unknown, however, is the amount of time recovery will take. But a new study helps quantify the outcome: An article published last month in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) said patients can expect to regain full functionality within two to three years after hip fracture surgery.The study also looked at the long-term psychosocial limitations of patients compared to peer groups and concluded that socialization may aid in recovery.

“We wanted to take a closer look at outcomes including mobility, driving frequency, depression and the ability to participate in activities outside the home, such as shopping, working and volunteering, because these are all important factors in maintaining ones’ independence and returning to normalcy following a hip fracture,” said Timothy Bhattacharyya, M.D., FAAOS, lead study author, orthopedic surgeon, and head of clinical orthopedic research at the National Institute of Arthritis and Musculoskeletal and Skin Diseases in Bethesda, Md. 
 
According to the American Academy of Orthopaedic Surgeons (AAOS), each year, more than 300,000 people in the United States sustain a hip fracture, the majority of which occur in patients 65 years or older, who are injured in household or community falls. Additionally, there is a 20 percent mortality rate within the first year after hip fracture.
 
To provide patients with clearer expectations of the ongoing recovery process, Bhattacharyya utilized the National Health and Aging Trends Study (NHATS), a large longitudinal study on aging, to conduct an analysis of trends after a hip fracture. Bhattacharyya and his team pulled data for patients aged 65 and older who sustained one hip fracture between 2011 and 2016 and were still driving and leaving the house regularly at the time of the fracture. This data was compared to a national, aged-matched control group with similar demographics and comorbidities. 
 
The study found that one year after the fracture, hip fracture patients are less likely to drive (76 percent of hip fracture patients vs. 95 percent of control group), less likely to leave the house (86 percent vs. 99 percent), less likely to work and volunteer (17 percent vs. 44 percent) and more likely to feel depressed on most days (20 percent vs. 10 percent). Hip fracture patients were also more likely to report being kept from their favorite activity due to their health for up to two years after fracture. 
 
The long-term prognosis for patients demonstrates measurable gains in function and well-being, as there was no statistically significant difference observed in driving frequency, leaving the house regularly or working/volunteering between subjects two to three years after fracture. 
 
Bhattacharyya points to the important role large social networks play in recovery and encourages patients to push themselves to interact with friends and family. The study found that patients with large social networks were more likely to work or volunteer compared to those with small social networks (30 percent vs. 12 percent). Patients with large social networks also tended to have fewer comorbidities. 
 
“There’s a natural tendency to not want to share your burden with others; however, you really have to do the opposite to avoid isolation,” said Bhattacharyya. “With a greater understanding of how socialization aids recovery, I now proactively encourage my patients to reach out to their friends and family to interact. Given the pandemic, patients can participate in activities with a few select people and prioritize online social interaction with larger groups.” 
 
This research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under project number ZIAAR041153.