Hip fracture-great steps forward but we still need better evidence. A commentary on NICE CG124 and QS16 on fractured neck of femur

Age Ageing. 2018 Sep 1;47(5):630-632. doi: 10.1093/ageing/afy099.

Abstract

The National Institute for Health and Care Excellence (NICE) updated its Clinical Guideline and its Quality Standard on hip fracture in 2017. Three quality statements relate to the organisation of care-having a multidisciplinary hip fracture programme, and both operating and starting rehabilitation without delay-while three relate to surgical aspects, the most recent being the requirement to offer total hip replacement rather than hemiarthroplasty for those with displaced intracapsular fractures who could mobilise outdoors with a stick. Some evidence exists to support this, but the timely provision of this more complex and specialised operation presents a logistical challenge to many units. The evidence for many more general aspects of the care of hip fracture patients is still extrapolated from other populations, and more research is needed to guide the care of this specific group.

MeSH terms

  • Age Factors
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Hip / instrumentation
  • Arthroplasty, Replacement, Hip / rehabilitation
  • Arthroplasty, Replacement, Hip / standards*
  • Biomechanical Phenomena
  • Clinical Decision-Making
  • Evidence-Based Medicine / standards*
  • Femoral Neck Fractures / diagnostic imaging
  • Femoral Neck Fractures / physiopathology
  • Femoral Neck Fractures / surgery*
  • Hemiarthroplasty / adverse effects
  • Hemiarthroplasty / instrumentation
  • Hemiarthroplasty / rehabilitation
  • Hemiarthroplasty / standards*
  • Hip Joint / diagnostic imaging
  • Hip Joint / physiopathology
  • Hip Joint / surgery*
  • Humans
  • Patient Selection
  • Practice Guidelines as Topic / standards*
  • Recovery of Function
  • Risk Factors
  • Time-to-Treatment / standards
  • Treatment Outcome
  • Waiting Lists