Period prevalence and timing of contralateral hip fractures: An eighteen year retrospective cohort study, systematic review and meta-analysis of the literature

Purpose: Second contralateral hip fractures (SCHF) are relatively uncommon. The overall prevalence of this is poorly reported in literature.

Methods: We performed a single centre retrospective cohort study in patients >50 years old who sustained a SCHF between 1st of January 2005 and 30th of April 2023. A systematic search of the literature was then performed by searching PubMed, Embase, and Web of Science from the date of inception of each database through to the 22nd of February 2024. A meta-analysis was conducted to estimate the prevalence of SCHF and hip fracture pattern symmetry, incorporating both our results and that previously reported in literature.

Results: Our cohort study showed a period prevalence of 1.7 % within 1 year and 2.8 % within 2 years following a hip fracture. 65 studies were identified using our search strategy. The overall prevalence of SCHF was 7.3 % [95 % CI: 6.3–8.4]. Meta-regression suggested that studies conducted in Europe and North America showed higher prevalence than studies conducted in Asia. A similar fracture pattern was seen in 72.1 % [95 % CI: 69.7–74.4] of patients with SCHF.

Conclusion: SCHF are relatively uncommon. When they do occur, it is usually within 2 years of the index fracture. Asian populations had lower prevalence of SCHF when compared to their European and North American counterparts. Hip fracture pattern is symmetrical in most patients with a SCHF.