Osteoporosis therapy reduced periprosthetic fracture risk after hip fracture arthroplasty
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LAS VEGAS — Osteoporosis treatment started within 1 year of arthroplasty for a hip fracture was associated with a lower cumulative incidence of periprosthetic fractures vs. no osteoporosis treatment, presented data showed.
Patients who undergo hip arthroplasty for a hip fracture are at risk for subsequent periprosthetic fractures because they have either poor bone quality or risks factors associated with falls, according to information Matthew J. Kinnard, MD, presented at the American Academy of Orthopaedic Surgeons Annual Meeting.
Kinnard and colleagues performed a retrospective cohort analysis of patients in the PearlDiver database who were aged at least 65 years and underwent hip arthroplasty for femoral neck fractures. Researchers identified the patients in the study using ICD codes 9 and 10 and stratified the patients based on whether they began anti-osteoporotic treatment within 1 year after arthroplasty.
“Patients who underwent arthroplasty for femoral neck fractures and were prescribed osteoporosis therapy in the first postoperative year were at a 33.7% lower risk of periprosthetic fractures than those who were prescribed no therapy,” Kinnard said. “Specific benefits of osteoporosis therapy after hip fractures include reduction of early fracture risk and a decrease in all-cause mortality.”
The osteoporosis-treated group consisted of 2,026 patients and the non-treated group consisted of 33,639 patients. The mean follow-up was 4.7 years in the treated group and 0.4 years in the non-treated group. Osteoporosis treatment status was determined from outpatient prescription information, Kinnard said.
“Overall, the log rank test showed the cumulative incidence of periprosthetic fractures in patients treated with osteoporosis medications within 1 year of hip arthroplasty was significantly different than those who were not treated, with those who received osteoporosis treatment [having] a 3.88% fracture risk compared to 5.92% for those who were untreated,” he said.
Although the benefits of osteoporosis therapy after hip fractures are known, more than 80% of patients with a fragility fracture are not treated with osteoporosis therapy, which is a finding suggested in the literature, according to Kinnard.
“Treatment of osteoporosis, which may include nutritional optimization, calcium and vitamin D supplementation or the use of pharmacologic agents, should be initiated in patients who sustain hip fractures. The information provided by our study may be helpful to patients and providers as they consider starting osteoporosis therapy following hip fractures,” he said.
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Kinnard MJ, et al. Paper 110. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 7-11, 2023; Las Vegas.
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