Research Articles

Study of Contralateral Hip in Patients with Hip Fracture

Abstract

Background: This study was done to know whether patients with hip injury have pre-existing osteoporosis due to which, the patient sustained the fracture, subsequent fracture of the contralateral hip, any osteoarthritic changes of the contralateral hip at the time of index fracture, and ten-year probability of a major osteoporotic fracture by calculating fracture risk assessment percentage (FRAX%).

 

Methods: 34 patients were evaluated for age, gender, body mass index (BMI), fracture type, Singh index, bone mineral density (BMD), T-scores using dual-energy X-ray absorptiometry (DEXA) scan, and ten-year probability of fracture using FRAX%.

 

Results: Average age of the patients with hip fractures was 72.1 years. About 85% of patients were women. 67.6% of the patients were with BMI of 18.5-25 kg/m2. The Singh index for osteoporosis fell in grades 2 and 3 in most patients. The mean interval between index fracture and contralateral hip injury was 4.25 years. Osteoarthritis of the contralateral hip was seen in 9%. The probability in ten years of hip fracture in 30 indexed patients using the FRAX% tool was 15%, and for 4 patients who were having bilateral hip fractures was 22.75%. There was a significant relationship between FRAX% with the Singh index and osteoarthritis of the contralateral hip. FRAX% was high in female patients.

 

Conclusion: Contralateral hip fracture in patients with osteoporosis was high in women and patients with low and high BMI. Fractures were also high in patients with low Singh index and T-scores. FRAX% increased with an increase in age and increased with a decrease in T-score.

 

1. Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002;359(9319):1761-7. doi: 10.1016/S0140-6736(02)08657-9. [PubMed: 12049882].

2. Shafiei SH, Ghaderzadeh S, Rastegar M, Siavashi B, Golbakhsh M, Mortazavi SJ. Mortality rate and quality of life in patients with intertrochanteric fractures treated with dynamic hip screw. J Orthop Spine Trauma. 2022;8(2):52-6. doi: 10.18502/jost.v8i2.9311.

3. Ghasemi MA, Ghadimi E, Shamabadi A, Mortazavi SJ. The perioperative management of antiplatelet and anticoagulant

drugs in hip fractures: Do the surgery as early as possible. Arch

Bone Jt Surg. 2022;10(6):490-500. doi: 10.22038/ABJS.2021.56396.2800. [PubMed: 35928910]. [PubMed Central: PMC9295588].

4. Hussain KSA, Reddy ASK, Raju M, Patnala C. Influence of risk factors and comorbidities on postoperative complications
and outcomes after hip fracture surgery in the elderly. J
Orthop Spine Trauma. 2022;8(4). doi:
https://doi.org/10.18502/jost.v8i4.10452.

5. Blonk MC, Erdtsieck RJ, Wernekinck MG, Schoon EJ. The fracture and osteoporosis clinic: 1-year results and 3-month

compliance. Bone. 2007;40(6):1643-9. doi: 10.1016/j.bone.2007.01.023. [PubMed: 17433805].

6. van Helden S, Cals J, Kessels F, Brink P, Dinant GJ, Geusens P. Risk of new clinical fractures within 2 years following a fracture. Osteoporos Int. 2006;17(3):348-54. doi: 10.1007/s00198-005-2026-x. [PubMed: 16378167].

7. Weatherall M. Contralateral fracture of the proximal femur. Implications for planning trials. J Bone Joint Surg Br. 1999;81(1): 77-9. doi: 10.1302/0301-620x.81b1.8959. [PubMed: 10068008].

8. Vochteloo AJ, Borger van der Burg BL, Roling MA, van Leeuwen DH, van den Berg P, Niggebrugge AH, et al. Contralateral hip fractures and other osteoporosis-related fractures in hip fracture patients: Incidence and risk factors. An observational cohort study of 1,229 patients. Arch Orthop Trauma Surg. 2012;132(8):1191-7. doi: 10.1007/s00402-012-1520-9. [PubMed: 22526197]. [PubMed Central: PMC3400761].

9. Reider L, Beck TJ, Hochberg MC, Hawkes WG, Orwig D, YuYahiro JA, et al. Women with hip fracture experience greater loss of geometric strength in the contralateral hip during the year following fracture than age-matched controls. Osteoporos Int. 2010;21(5):741-50. doi: 10.1007/s00198-009-1000-4. [PubMed: 19572093]. [PubMed Central: PMC2847041].

10. Dirschl DR, Piedrahita L, Henderson RC. Bone mineral density 6 years after a hip fracture: A prospective, longitudinal study. Bone. 2000;26(1):95-8. doi: 10.1016/s8756-3282(99)00234-3. [PubMed: 10617162].

11. Koot VC, Kesselaer SM, Clevers GJ, de Hooge P, Weits T, van der Werken C. Evaluation of the Singh index for measuring osteoporosis. J Bone Joint Surg Br. 1996;78(5):831-4. [PubMed: 8836082].

12. Kanis JA, McCloskey EV, Johansson H, Strom O, Borgstrom F, Oden A. Case finding for the management of osteoporosis with FRAX--assessment and intervention thresholds for the UK. Osteoporos Int. 2008;19(10):1395-408. doi: 10.1007/s00198-008-0712-1. [PubMed: 18751937].

13. Yamanashi A, Yamazaki K, Kanamori M, Mochizuki K, Okamoto S, Koide Y, et al. Assessment of risk factors for second hip fractures in Japanese elderly. Osteoporos Int. 2005;16(10): 1239-46. doi: 10.1007/s00198-005-1835-2. [PubMed: 15729479].

14. Angthong C, Suntharapa T, Harnroongroj T. Major risk factors for the second contralateral hip fracture in the elderly. Acta

Orthop Traumatol Turc. 2009;43(3):193-8. doi: 10.3944/AOTT.2009.193. [PubMed: 19717935].

15. Palermo A, Tuccinardi D, Defeudis G, Watanabe M, D'Onofrio L, Lauria PA, et al. BMI and BMD: The potential interplay between obesity and bone fragility. Int J Environ Res Public Health. 2016;13(6). doi: 10.3390/ijerph13060544. [PubMed: 27240395]. [PubMed Central: PMC4924001].

16. Nymark T, Lauritsen JM, Ovesen O, Rock ND, Jeune B. Short time-frame from first to second hip fracture in the Funen County Hip Fracture Study. Osteoporos Int. 2006;17(9):1353-7. doi: 10.1007/s00198-006-0125-y. [PubMed: 16823545].

17. Chevalley T, Guilley E, Herrmann FR, Hoffmeyer P, Rapin CH, Rizzoli R. Incidence of hip fracture over a 10-year period

(1991-2000): Reversal of a secular trend. Bone. 2007;40(5):

1284-9. doi: 10.1016/j.bone.2006.12.063. [PubMed: 17292683].

18. Schroder HM, Petersen KK, Erlandsen M. Occurrence and incidence of the second hip fracture. Clin Orthop Relat Res. 1993;(289):166-9. [PubMed: 8472408].

19. Berry SD, Samelson EJ, Hannan MT, McLean RR, Lu M, Cupples LA, et al. Second hip fracture in older men and women: The Framingham Study. Arch Intern Med. 2007;167(18):1971-6. doi: 10.1001/archinte.167.18.1971. [PubMed: 17923597].

20. Kling JM, Clarke BL, Sandhu NP. Osteoporosis prevention, screening, and treatment: A review. J Womens Health (Larchmt). 2014;23(7):563-72. doi: 10.1089/jwh.2013.4611. [PubMed: 24766381]. [PubMed Central: PMC4089021].

21. Franklin J, Englund M, Ingvarsson T, Lohmander S. The association between hip fracture and hip osteoarthritis: A case-control study. BMC Musculoskelet Disord. 2010;11:274. doi:

10.1186/1471-2474-11-274. [PubMed: 21110879]. [PubMed Central: PMC3006377].

22. National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Washington, DC: NOF; 2010.
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IssueVol 9, No 2 (2023) QRcode
SectionResearch Articles
DOI https://doi.org/10.18502/jost.v9i2.12627
Keywords
Osteoporosis T-Score Contralateral hip fracture Fracture Risk Assessment percentage FRAX%

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How to Cite
1.
Babu S, Gopal V, Ansari Shaik W. Study of Contralateral Hip in Patients with Hip Fracture. J Orthop Spine Trauma. 2023;9(2):78-81.