Issue: January 2022

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December 16, 2021
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AAOS releases updated clinical practice guidelines for management of hip fractures

Issue: January 2022
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The American Academy of Orthopaedic Surgeons released an update to the clinical practice guidelines for management of hip fractures in adults aged 55 years and older.

This update replaces the first edition of the clinical practice guidelines, which were released in 2014 and covered a patient population of 65 years of age and older, according to a press release from the AAOS. To refine and improve treatment recommendations for hip fracture patients, the release noted that more than 80% of the evidence-based recommendations included in the previous guidelines are updated in this latest edition.

Two significant updates to the recommendations include strong evidence for expanding the approach to care with an interdisciplinary approach to decrease mortality and complications and improve outcomes, as well as the strong evidence to recommend surgery within 24 to 48 hours, the release noted.

Julie Switzer
Julie Switzer

“These two recommendations go hand in hand,” Julie Switzer, MD, FAAOS, co-chair of the clinical practice guideline workgroup, said in the AAOS release. “An interdisciplinary care program should begin the moment a patient is admitted to the hospital as it is an essential part of driving efficiencies to get a patient into the operation room within 24 to 48 hours. Following surgery, this team, which can consist of geriatric, orthopedic, nursing, dietary and rehabilitation providers, are the key to driving good outcomes and helping patients navigate this sentinel event.”

The release noted the guideline also cites strong evidence supporting the use of cemented femoral stems for patients undergoing arthroplasty for femoral neck fractures, and moderate evidence demonstrating no clear difference in measured outcomes or risk based on surgical approach in patients undergoing treatment of femoral neck fractures with hip arthroplasty.

Mary O’Connor
Mary O’Connor

“Hip fractures are a serious public health issue, specifically for our seniors,” Mary O’Connor, MD, FAAOS, co-chair of the clinical practice guideline development group, said in the AAOS release. “For this patient population, a hip fracture can become a life-altering event that requires surgery and may result in a decreased quality of life, increased morbidities and a higher rate of mortality within 1 year after surgery. Due to the increased prevalence of hip fractures in older U.S. adults, I commend the AAOS for recognizing the importance of funding this [clinical practice guideline] to update guidance based on the latest research and best available evidence to improve patient care.”

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