Incidence, risk factors, prognosis of periprosthetic fractures post hip fracture: unveiling protective role of anti-osteoporotic medication
- 08.09.2025
- Original Article
Erschienen in:
- Verfasst von
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Shao-Wei Lo
Shao-Wei Lo
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Shao-Wei Lo and Hung-Kuan Yen contributed equally.
- Harvard T.H. Chan School of Public Health, Boston, USA
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Hung-Kuan Yen
Hung-Kuan Yen
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Shao-Wei Lo and Hung-Kuan Yen contributed equally.
- Department of Orthopaedic Surgery, National Taiwan University Hospital, Taipei, Taiwan
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Chi-Ching Huang
Chi-Ching Huang
- Department of Emergency Medicine, Lehigh Valley Health Network, Allentown, USA
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Yi-Chien Lu
Yi-Chien Lu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, Taiwan
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Ho-Min Chen
Ho-Min Chen
- Health Data Research Center, National Taiwan University, Taipei, Taiwan
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Jou-Wei Lin
Jou-Wei Lin
- Cardiovascular Center, National Taiwan University Hospital Yun Lin Branch, Douliu, Yunlin, Taiwan
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Shau-Huai Fu
Korrespondierender Autor Shau-Huai Fu
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Shao-Wei Lo and Hung-Kuan Yen contributed equally.
- Department of Orthopaedic Surgery, National Taiwan University Hospital, Taipei, Taiwan
- Department of Orthopedic Surgery, National Taiwan University Hospital Yun Lin Branch, Yunlin, Taiwan
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Chen-Yu Wang
Korrespondierender Autor Chen-Yu Wang
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Shao-Wei Lo and Hung-Kuan Yen contributed equally.
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, Taiwan
- Department of Pharmacy, National Taiwan University Hospital Yun Lin Branch, Douliu, Yunlin, Taiwan
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- Erschienen in
- Osteoporosis International | Ausgabe 12/2025
Abstract
Summary
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.
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- Titel
- Incidence, risk factors, prognosis of periprosthetic fractures post hip fracture: unveiling protective role of anti-osteoporotic medication
- Verfasst von
-
Shao-Wei Lo
Hung-Kuan Yen
Chi-Ching Huang
Yi-Chien Lu
Ho-Min Chen
Jou-Wei Lin
Shau-Huai Fu
Chen-Yu Wang
- Publikationsdatum
- 08.09.2025
- Verlag
- Springer London
- Erschienen in
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Osteoporosis International / Ausgabe 12/2025
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965 - DOI
- https://doi.org/10.1007/s00198-025-07670-3
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