Dr. Song Sang-ho, Wellton Hospital: "Hip Fracture Patients Must Walk Again — Fast"

"Hip fractures can devastate an elderly person's health in an instant."

As South Korea's aging population accelerates, the number of elderly fracture patients continues to rise. Dr. Song Sang-ho, Director of Wellton Hospital, distills the seriousness of hip fractures in this single sentence.

Prolonged bed rest can trigger life-threatening complications — pneumonia, thrombosis, pressure ulcers — rapidly deteriorating a patient's condition. Reports indicate that approximately 20% of hip fracture patients die within one year, and 50–60% suffer lasting mobility impairment even after recovery.

For this reason, hip fracture treatment is about far more than simply mending bone : the central challenge is how quickly the patient's walking function can be restored.

■ The Core of Hip Fracture Treatment: Getting Patients Walking Again

Dr. Song repeatedly emphasizes that the key to hip fracture treatment is 

getting patients back on their feet as quickly as possible. The moment a patient can leave the bed and move — even minimally — physical function rebounds faster, and life-threatening complications can be avoided.

■ Cemented vs. Uncemented Femoral Stem: What's the Difference?

When the hip joint is fractured, surgeons perform arthroplasty — replacing the damaged joint with an artificial implant. The femoral stem (the implant component that anchors the artificial joint) is broadly classified into two types: cemented and uncemented.

Cemented stems use bone cement to fix the implant securely in place. Uncemented stems rely on direct bone integration without cement.

While most medical institutions use uncemented stems, Dr. Song actively employs cemented femoral stems. The additional step of injecting bone cement achieves a significantly more stable fixation.

■ Why Cemented Stems for the Very Elderly?

"Patients in their 60s–70s with good bone quality may do well with an uncemented stem," Dr. Song explains, "but the majority of hip fracture patients are in their 80s–90s with severe osteoporosis. In these cases, an uncemented stem may not provide sufficient fixation — increasing the risk of fracture both during and after surgery."

By contrast, cemented stems reinforce weakened bone and provide stable fixation immediately after surgery, enabling earlier ambulation and rehabilitation.

This is why the United States, the United Kingdom, and major European nations strongly recommend cemented arthroplasty for elderly hip fracture patients.

■ Clinical Evidence from Wellton Hospital

Dr. Song underscores the practical advantages: "Cemented stems 

provide superior fixation even in severely osteoporotic bone, enabling patients to walk earlier and return to daily life faster. Although the procedure takes longer, it is ultimately a wiser choice that delivers safer outcomes and faster functional recovery."

Data support this approach. According to an analysis by the Health Insurance Review and Assessment Service (HIRA), Wellton Hospital's dislocation rate within 3 months of surgery was 0.172% — approximately 87% lower than the hospital-level average of 1.306%.

■ A Call for Practice Change in Korea

Dr. Song points to the reality that cemented implants remain underutilized in South Korea, and urges a shift: 

"Korea must move toward routinely using cemented arthroplasty as the standard of care for elderly patients and those with fragile bones."

In an era that demands personalized medicine, hip fracture surgery must move beyond a one-size-fits-all approach. 

A tailored treatment strategy — one that accounts for the patient's age, bone condition, and overall health — is now essential.