Incidence, risk factors, prognosis of periprosthetic fractures post hip fracture: unveiling protective role of anti-osteoporotic medication
Journal
Osteoporosis International
ISSN
0937-941X
1433-2965
Date Issued
2025-09-08
Author(s)
Lo, Shao-Wei
Yen, Hung-Kuan
Huang, Chi-Ching
Lu, Yi-Chien
Chen, Ho-Min
Wang, Chen-Yu
Abstract
People with a hip fracture are prone to break the bone around the metal repair, causing severe health issues. This study found that initiating anti-osteoporotic medication soon after the first fracture halves that risk, highlighting the benefit of early osteoporosis treatment.
Background: Hip fractures pose significant clinical challenges, often leading to prolonged hospitalization, reduced quality of life, and increased risk of subsequent fractures. Periprosthetic fractures (PPFs), which occur near hip fixation devices, are particularly concerning due to their high morbidity and mortality. This study evaluates the incidence, risk factors, and outcomes of PPFs and examines whether initiating anti-osteoporotic medication (AOM) after hip fracture reduces PPF risk.
Methods: We conducted a retrospective cohort study using Taiwan's National Health Insurance Research Database, analyzing 48,082 patients with hip fractures from January 2016 to December 2018. We assessed the incidence, risk factors, and prognosis of PPFs, including mortality and subsequent major osteoporotic fractures (SMOFs), and compared these outcomes to those with contralateral second hip fractures (2HFs). The effect of AOM initiation post-hip fracture was also evaluated.
Results: Among the cohort, 443 patients (0.9%) developed PPFs, and 2285 (4.8%) experienced 2HFs. Patients aged 60-69 had a higher PPF risk. AOM use was significantly associated with reduced risk of both PPFs (HR 0.50; 95% CI, 0.39-0.65) and 2HFs (HR 0.85; 95% CI, 0.77-0.93). Five-year mortality was comparable between PPF and 2HF groups (33.0% vs. 30.0%), but SMOFs were more frequent in PPF cases (7.5% vs. 3.7%).
Conclusions: PPFs are a serious complication following hip fracture. Post-fracture AOM initiation appears to lower the risk of PPFs and 2HFs, supporting its role as a key preventive strategy. Further research is needed to optimize treatment protocols.
Subjects
Hip fractures
Osteoporotic treatments
Periprosthetic fractures
Prevention
Publisher
Springer Science and Business Media LLC
Type
journal article