【Abstract】 Objective To study the application of artificial joint replacement in elderly hip fracture and its effect on BGP, PTH and BALP. Methods 74 elderly patients with osteoporotic fractures of hip were enrolled in our hospital from December 2014to March 2016. All the patients were divided into control group and observation group according to the random number table method. The control group was treated with conventional internal fixation. The patients in the observation group were treated with artificial joint replacement. The patients in each group were treated with artificial joint replacement. The Harris score, BGP, PTH and BALP contents were compared between the two groups before and after treatment.Result The Harris score of the two groups after treatment were higher than those before treatment. The hip joint function of observation group 12 months after treatment (9411 ±352) was higher than that of the control group (9068 ±410) (P<005). The bone mineral density of the two groups was not statistically significantly different (P> 005).The bone mineral density of observation group of 6 and 12 months after treatment were higher than that of control group (P < 005). BGP, PTH and BALP of the two groups were not statistically significantly different (P>005). BGP, PTH and BALP 12 months after treatment of observation group were higher than that control group BGP (P<005). The excellent rate of observation group (9730%) was higher than that of control group (83.78%) (P<005). The nausea and vomiting of observation group (811%) was less than that of control group (2703%) (P<005).Conclusion Artificial joint replacement in elderly hip fractures in patients with osteoporosis can effectively improve the patients with bone metabolic index combined with anti osteoporosis drug therapy.