In this episode of Hipcast, we’re joined by Dr Linda Sheahan, palliative care physician and clinical ethics consultant, alongside Professor Jacqui Close, orthogeriatrician and geriatric medicine Co-Chair of the Australian and New Zealand Hip Fracture Registry.

Together, we explore the importance of goals of care discussions in the context of hip fracture - why they matter, when they should occur, and how they can support patients, families and clinicians during what is often a sudden and life-changing event.

Linda and Jacqui discuss the practical and ethical challenges of decision-making after hip fracture, including how to navigate uncertainty, align care with a person’s values and preferences, and approach conversations about surgery, recovery, frailty, prognosis and quality of life.

We also consider how goals of care discussions can be embedded into routine hip fracture care, and why these conversations are not about limiting care, but about ensuring that treatment decisions are informed, compassionate and person-centred.

Importantly, the conversation highlights that high-quality hip fracture care is not only about timely surgery and rehabilitation, but also about listening carefully to what matters most to the person at the centre of care.

You can find resources on Australian Advanced Care Planning resources here. 

🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.

In this episode of Hipcast, we’re joined by Dr Angela Sheu, Staff Specialist Endocrinologist at St Vincent’s Hospital Darlinghurst, Conjoint Senior Lecturer at UNSW, and Research Officer at the Victor Chang Cardiac Research Institute, alongside Professor Jacqui Close, internationally recognised orthogeriatrician and co-chair of the ANZHFR.

Together, we unpack the updated Healthy Bones Australia recommendations and what they mean for clinicians caring for people after hip fracture. Angela and Jacqui discuss the persistent osteoporosis treatment gap, why the post-fracture period is a critical window for intervention, and how the latest evidence is shaping recommendations around treatment initiation and sequencing.

We also explore the practical realities of implementing these guidelines across hospital and community settings, including the role of fracture liaison services, shared care, and strategies to reduce the risk of patients being lost to follow-up.

Importantly, the conversation highlights that a hip fracture should be seen not only as an acute event requiring surgical management, but also as an opportunity to prevent the next fracture through timely, coordinated osteoporosis care.

🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.

In this episode of Hipcast, we’re joined by Associate Professor Chris Wall, Director of the Department of Orthopaedics at Toowoomba Hospital, Orthopaedic Surgery Co-Chair of the Australian and New Zealand Hip Fracture Registry, and Assistant Deputy Registry Clinical Director for the Australian Orthopaedic Association National Joint Replacement Registry.

In this conversation, we explore periprosthetic femur fractures - an increasingly common and complex challenge as rates of joint replacement continue to rise. Chris outlines what these fractures are, who they affect, and why they matter in modern orthopaedic and orthogeriatric care.

We discuss key aspects of management, including surgical decision-making and the challenges of fixation versus revision, as well as what current data tells us about patient outcomes.

Importantly, the episode highlights why including periprosthetic fractures in registry data is critical, and how this can support better understanding, improved care, and system-wide quality improvement.

🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.

In this episode of Hipcast, we’re joined by Professor Kim Delbaere, Discipline Lead of Physiotherapy at UNSW Sydney and Senior Principal Research Scientist at Neuroscience Research Australia, as well as Immediate Past President of the Australian and New Zealand Falls Prevention Society.

In this conversation, we explore the important relationship between falls prevention and hip fracture care, and why preventing falls remains a critical – but often under-recognised – part of improving outcomes for older adults.

Kim discusses the work of the Falls Prevention Alliance Australia, the current national landscape of falls prevention, and some of the key challenges in translating strong evidence into real-world practice across health systems and communities.

Importantly, the discussion highlights the role clinicians, health services, and communities can play in strengthening falls prevention efforts, along with practical insights for those working in hip fracture care.

🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.

In this episode of Hipcast, we’re joined by the Waitematā Hip Fracture Team in Aotearoa New Zealand, winners of the ANZHFR Golden Hip Award for five consecutive years.

Dr Min Yee Seow (Clinical Lead, Orthogeriatric Service), Vandhana Sharan (Orthopaedic Charge Nurse), and Kyleigh Pailman (Orthopaedic Physiotherapist) share how their multidisciplinary team has built one of the highest-performing hip fracture services across Australia and New Zealand.

The conversation explores the practical systems, team culture, and small operational changes that help Waitematā consistently deliver high-quality care – from coordinated multidisciplinary teamwork and early mobilisation to managing common challenges such as delirium and patient flow.

Importantly, the team reflects on the lessons learned along the way and offers practical advice for services looking to improve their own hip fracture care.

Whether you work in orthopaedics, geriatrics, nursing, physiotherapy, or health service leadership, this episode provides valuable insights into how strong teamwork and continuous improvement can translate into better outcomes for patients with hip fracture.

🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.

In this episode of Hipcast, we’re joined by Lauren Wulff, a community physiotherapist with the AWHI Early Supported Discharge Team in the Hutt Valley, New Zealand. With limited access to inpatient rehabilitation beds, Lauren and her team have built a comprehensive, high-functioning community-based rehabilitation model that supports patients from the moment they leave hospital.

Lauren shares how the Hutt Valley service delivers safe early discharge, provides intensive home-based rehabilitation, and equips patients and whānau with the skills, confidence, and support they need to regain mobility and independence.

Whether you work in orthopaedics, geriatrics, allied health, general practice, or community care, this episode provides actionable insights into delivering high-quality rehabilitation outside the traditional ward environment.

🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.

In this episode of Hipcast, we explore the newly released Clinical Standards for Secondary Fracture Prevention Programs, developed by the SOS Fracture Alliance (SOSFA) and released in November 2025.

Joining us are:

• Professor Markus Seibel, Chair of the SOS Fracture Alliance and Professor of Medicine at The University of Sydney
• Dr Lauren Nacey, Geriatrician and leader in secondary fracture prevention
• Professor Rudi Jaarsma, Academic and Clinical Director of Orthopaedic Surgery at Flinders Medical Centre
• Dr Fiona Mackie, consumer representative with lived experience of osteoporosis and fracture risk

Together, they discuss why these standards were developed, the evidence and expertise that informed them, and how they aim to improve care for people who sustain a fragility fracture.

🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.

Dr Grace Taylor from the Department of Orthopaedic Surgery, North Shore Hospital, Auckland, New Zealand joins to share findings from her research "Standard of care and outcomes for Māori patients with neck of femur fractures" published in the ANZ Journal of Surgery. 

In this episode of Hipcast, we speak with three clinical experts about the complexities of surgical timing in hip fracture patients who are taking SGLT2 inhibitors and GLP-1 receptor agonists.

Professor Jacqueline Close (Consultant Geriatrician, Prince of Wales Hospital / Neuroscience Research Australia), A/Prof Katherine Tonks (Endocrinologist, Sydney Endocrinology / St Vincent’s Hospital) and Dr Louisa Lowes (Anaesthetist and Director of Perioperative Medicine, Prince of Wales Hospital) share insights from their respective disciplines on balancing surgical urgency with medication-related risks.

The discussion explores:

• Mechanisms and perioperative considerations of SGLT2 inhibitors and GLP-1 agonists
• How these agents influence timing and safety of hip fracture surgery
• Interdisciplinary strategies to minimise perioperative complications
• Practical take-aways for clinicians

🔗 Resources mentioned:

• 1. Australian Diabetes Society (ADS):
     Peri-operative Management of Diabetes Medications
  2. ANZCA Safety Alert: ALERT UPDATE May 2023 Periprocedural Diabetic Ketoacidosis (DKA) with SGLT2 Inhibitor Use In People with Diabetes
  3. ANZCA Safety Alert: Clinical Practice Recommendations regarding patients taking GLP-1 receptor agonists and dual GLP-1/GIP receptor co-agonists prior to anaesthesia or sedation for surgical and endoscopic procedures.
  4. Australian and New Zealand Hip Fracture Registry (ANZHFR):
     Clinical Care Standards and Annual Report
  5. A/Prof Katherine Tonks resource: Is your patient on a SGLT-2 Inhibitor?
  6. ANZCA Patient Instructions: Preparing for your medical procedure when taking some diabetes and/or weight loss medications

🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.

In this special episode of Hipcast, host Dr Niamh Dove speaks with Nick May, husband and carer of his wife Fleur who sustained a hip fracture and underwent hospital treatment and recovery.

Nick shares his reflections on navigating the hospital experience, the realities of recovery at home, and how life changes after a hip fracture - from the viewpoint of the person providing day-to-day care. His story highlights the essential role of carers in supporting recovery and what health professionals can learn from their perspective.

This episode is brought to you by the Australian and New Zealand Hip Fracture Registry (ANZHFR), dedicated to improving outcomes and experiences for people with hip fracture and their families.