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Multicenter Study
. 2010 May;21(5):741-50.
doi: 10.1007/s00198-009-1000-4. Epub 2009 Jul 2.

Women with hip fracture experience greater loss of geometric strength in the contralateral hip during the year following fracture than age-matched controls

L Reider  1 , T J Beck, M C Hochberg, W G Hawkes, D Orwig, J A YuYahiro, J R Hebel, J Magaziner; Study of Osteoporotic Fractures Research Group
Affiliations
Multicenter Study

Women with hip fracture experience greater loss of geometric strength in the contralateral hip during the year following fracture than age-matched controls

L Reider et al. Osteoporos Int. 2010 May.

Abstract

This study examined femur geometry underlying previously observed decline in BMD of the contralateral hip in older women the year following hip fracture compared to non-fractured controls. Compared to controls, these women experienced a greater decline in indices of bone structural strength, potentially increasing the risk of a second fracture.

Introduction: This study examined the femur geometry underlying previously observed decline in BMD of the contralateral hip in the year following hip fracture compared to non-fractured controls.

Methods: Geometry was derived from dual-energy X-ray absorptiometry scan images using hip structural analysis from women in the third cohort of the Baltimore Hip Studies and from women in the Study of Osteoporotic Fractures. Change in BMD, section modulus (SM), cross-sectional area (CSA), outer diameter, and buckling ratio (BR) at the narrow neck (NN), intertrochanteric (IT), and shaft (S) regions of the hip were compared.

Results: Wider bones and reduced CSA underlie the significantly lower BMD observed in women who fractured their hip resulting in more fragile bones expressed by a lower SM and higher BR. Compared to controls, these women experienced a significantly greater decline in CSA (-2.3% vs. -0.2%NN, -3.2% vs. -0.5%IT), SM (-2.1% vs. -0.2%NN, -3.9% vs. -0.6%IT), and BMD (-3.0% vs. -0.8%NN, -3.3% vs. -0.6%IT, -2.3% vs. -0.2%S) and a greater increase in BR (5.0% vs. 2.1%NN, 6.0% vs. 1.3%IT, 4.4% vs. 1.0%S) and shaft outer diameter (0.9% vs. 0.1%).

Conclusion: The contralateral femur continued to weaken during the year following fracture, potentially increasing the risk of a second fracture.

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Conflict of interest statement

Statement of Conflicts of Interest:

The lead author has no conflicts of interest to report.

The following co-authors report disclosures for:

Consultancies- J. Magaziner: Merck, Novartis, Amgen; M.C. Hochberg: Amgen, Merck, Novartis, Roche Pharmaceutical Co., Wyeth Pharmaceuticals, and Eli Lilly Inc. In neither case do the consultancies relate to the research presented in this paper.

Licensing arrangement- T.J. Beck: The HSA method has been licensed to Hologic Inc. by the Johns Hopkins University, employer of T.J. Beck.

Figures

Figure 1
Figure 1
Illustration of the geometry measured with HSA in a cross section and the corresponding differences between BHS3 and SOF Controls in baseline bone geometry adjusted for age, height and weight at three regions of the femur
Figure 2
Figure 2
Trends from baseline at the narrow neck in HSA a) BMD, b) CSA c) OD, d) SM, e) BR p values for a test of the null hypothesis that the between group changes over 12 months are the same
Figure 3
Figure 3
Trends from baseline at the intertrochanter in HSA a) BMD, b) CSA c) OD, d) SM, e) BR p values for a test of the null hypothesis that the between group changes over 12 months are the same.
Figure 4
Figure 4
Trends from baseline at the shaft in HSA a) BMD, b) CSA c) OD, d) SM, e)BR p values for a test of the null hypothesis that the between group changes over 12 months are the same
See this image and copyright information in PMC

References

    1. Vestergaard P, Rejnmark L, Mosekilde L. Has mortality after a hip fracture increased? J Am Geriatr Soc. 2007;55:1720–1726. - PubMed
    1. Magaziner J, Lydick E, Hawkes W, Fox KM, Zimmerman SI, Epstein RS, Hebel JR. Excess mortality attributable to hip fracture in white women aged 70 years and older. Am J Public Health. 1997;87:1630–1636. - PMC - PubMed
    1. Penrod JD, Litke A, Hawkes WG, Magaziner J, Koval KJ, Doucette JT, Silberzweig SB, Siu AL. Heterogeneity in hip fracture patients: age, functional status, and comorbidity. J Am Geriatr Soc. 2007;55:407–413. - PubMed
    1. Fredman L, Magaziner J, Hawkes W, Hebel JR, Fried LP, Kasper J, Guralnik J. Female hip fracture patients had poorer performance-based functioning than community-dwelling peers over 2-year follow-up period. J Clin Epidemiol. 2005;58:1289–1298. - PubMed
    1. Magaziner J, Fredman L, Hawkes W, Hebel JR, Zimmerman S, Orwig DL, Wehren L. Changes in functional status attributable to hip fracture: a comparison of hip fracture patients to community-dwelling aged. Am J Epidemiol. 2003;157:1023–1031. - PubMed

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