38,409 results match your criteria Fracture Hip


Timing of anti-osteoporosis medications initiation after a hip fracture affects the risk of subsequent fracture: A nationwide cohort study.

Bone 2020 May 25:115452. Epub 2020 May 25.

School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan. Electronic address:

Objective: The optimal time after hip fracture to start prophylactic anti-osteoporosis medications (AOMs) remains uncertain, especially in real-world practice. Therefore, we investigated how AOMs initiation timing affects the risk of subsequent osteoporotic fractures, and what factors influence AOMs prescription timing.

Method: Patients ≥50 years old with diagnostic codes indicating hospitalization for hip fracture (n = 77,930) were sampled from the Taiwan National Health Insurance Research Database; 9986 who were prescribed AOMs ≤1 year after a newly-diagnosed hip fracture were grouped into those who started AOMs from: ≤14 days (early); 15-84 days (very early); 85-252 days (late); and 253-365 days (very late). Read More

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http://dx.doi.org/10.1016/j.bone.2020.115452DOI Listing

Skin autofluorescence, a non-invasive biomarker for advanced glycation end-products, is associated with prevalent vertebral and major osteoporotic fractures: The Rotterdam Study.

J Bone Miner Res 2020 May 28. Epub 2020 May 28.

Department of Internal Medicine, Erasmus University Medical Center Rotterdam, The Netherlands.

Advanced glycation end-products (AGEs), that bind to type 1 collagen in bone and skin, have been implicated in reduced bone quality. The AGE reader measures skin autofluorescence (SAF), which might be regarded as a marker of long-term AGEs accumulation in tissues. We investigated the association of SAF with bone mineral density (BMD) and fractures in the general population. Read More

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http://dx.doi.org/10.1002/jbmr.4096DOI Listing

Outcomes of Femoral Neck Fractures Treated with Cannulated Internal Fixation in Elderly Patients: A Long-Term Follow-Up Study.

Orthop Surg 2020 May 28. Epub 2020 May 28.

Orthopedics Department, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.

Objectives: To evaluate the long-term efficacy of cannulated internal fixation in patients who sustain femoral neck fracture (FNF) and risk factors influencing the outcomes.

Methods: This retrospective study analyzed data from 73 elderly patients aged ≥60 years old, hospitalized for FNF and treated with cannulated internal fixation between August 2008 and July 2016. The inclusion criteria were: (i) patients aged ≥60 years; (ii) patients with recent femoral neck fracture, with times of injury ranging from 12-72 h; and (iii) patients who underwent Garden II-IV closed reduction and internal fixation. Read More

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http://dx.doi.org/10.1111/os.12683DOI Listing

Three-dimensional morphological analysis of the femoral neck torsion angle-an anatomical study.

J Orthop Surg Res 2020 May 27;15(1):192. Epub 2020 May 27.

Medical School of Chinese PLA, No. 28, Fuxing Road, Beijing, 100853, China.

Background: The femoral neck torsion angle (FNTA) is an important but often neglected parameter in assessments of the anatomical morphology of the femoral neck, which is often confused with the femoral neck anteversion angle (FNAA) in the current literature. Currently, the measurement methods reported in the literature all adopt the naked eye or two-dimensional (2D) visualization method, and the measurement parameters and details are not clearly defined. The objection of this research was to provide a reliable 3D method for determining the femoral neck axis, to improve the measurement method of the FNTA, and to analyze the anatomical and clinical significance of the results. Read More

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http://dx.doi.org/10.1186/s13018-020-01712-8DOI Listing

A risk assessment tool for predicting fragility fractures and mortality in the elderly.

J Bone Miner Res 2020 May 27. Epub 2020 May 27.

Osteoporosis and Bone Biology, Garvan Institute of Medical Research, Sydney, Australia.

Existing fracture risk assessment tools are not designed to predict fracture-associated consequences, possibly contributing to the current under-management of fragility fractures worldwide. We aimed to develop a risk assessment tool for predicting the conceptual risk of fragility fractures and consequences. The study involved 8965 people aged ≥60 years from the Dubbo Osteoporosis Epidemiology Study and the Canadian Multicentre Osteoporosis Study. Read More

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http://dx.doi.org/10.1002/jbmr.4100DOI Listing

High rates of implant fracture of a generic polished tapered femoral stem.

Hip Int 2020 May 27:1120700020925739. Epub 2020 May 27.

Orthopaedic Department, University Hospital Leuven, Leuven, Belgium.

Objectives: Cemented polished tapered stems have demonstrated excellent long-term outcomes. Based on this concept, many generic tapered stems have been released into the market. The aim of this study was to evaluate implant-related complications of 1 specific stem design. Read More

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http://dx.doi.org/10.1177/1120700020925739DOI Listing

Greater increase in femoral offset with use of collum femoris-preserving stem than Tri-Lock stem in primary total hip arthroplasty.

J Int Med Res 2020 May;48(5):300060520925999

Department of Osteonecrosis and Hip Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China.

Objective: This study was performed to compare the clinical outcomes and performance of the collum femoris-preserving (CFP) stem (Waldemar Link GmbH & Co., Hamburg, Germany) and the Tri-Lock stem (DePuy Orthopaedics, Warsaw, IN, USA) in terms of femoral offset (FO) and leg length reconstruction.

Methods: Clinical and radiographic data of patients who underwent total hip arthroplasty with either a CFP stem or Tri-Lock stem from January 2016 to March 2017 were compared (65 and 57 patients, respectively). Read More

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http://dx.doi.org/10.1177/0300060520925999DOI Listing

Treatment with zoledronate subsequent to denosumab in osteoporosis: a randomized trial.

J Bone Miner Res 2020 May 27. Epub 2020 May 27.

Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.

Discontinuing denosumab is associated with bone loss and possibly increased fracture risk. We investigated if treatment with zoledronate could prevent bone loss and if the timing of the zoledronate infusion influenced the outcome. 2-year randomized, open label, interventional study including 61 patients with osteopenia, discontinuing denosumab after 4. Read More

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http://dx.doi.org/10.1002/jbmr.4098DOI Listing

[Vitamin D in geriatric patients].

Internist (Berl) 2020 May 26. Epub 2020 May 26.

Klinik für Geriatrie, Universitätsspital Zürich, Rämistraße 100, 8091, Zürich, Schweiz.

Vitamin D deficiency is widespread in geriatric patients. While vitamin D deficiency is prevalent in about 50% of healthy older adults, the prevalence in geriatric patients with hip fracture increases to over 80%. This is partly due to the fact that sunlight is unreliable as the main source of vitamin D. Read More

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http://dx.doi.org/10.1007/s00108-020-00803-2DOI Listing

Combining diagnostic memory clinic with rehabilitation follow-up after hip fracture.

Eur Geriatr Med 2020 May 26. Epub 2020 May 26.

Department of Geriatric Medicine, Seinäjoki Central Hospital, Hanneksenrinne 7, 60220, Seinäjoki, Finland.

Purpose: Cognitive impairment and dementia are common in older hip fracture patients. We describe new diagnoses of cognitive disorders (NDCDs) and associated factors in a two-year post-hip fracture follow-up including the use of the diagnostic facilities of a memory clinic.

Methods: Data were collected on admission and at outpatient assessment 4-6 months post-hip fracture. Read More

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http://dx.doi.org/10.1007/s41999-020-00334-xDOI Listing

Night shift work and osteoporosis among female blue-collar workers in Poland - a pilot study.

Chronobiol Int 2020 May 26:1-11. Epub 2020 May 26.

Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine , Lodz, Poland.

Osteoporosis is an important public health problem worldwide. Although a number of factors that affect bone structure have been described; thus far, the current knowledge of occupational factors that may have an influence on bone tissue metabolism is strongly limited. Published studies indicate night shift work and the related circadian rhythm disruption may be considered as plausible underlying factors. Read More

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http://dx.doi.org/10.1080/07420528.2020.1763381DOI Listing

Circulating Myostatin Levels Decrease Transiently after Implantation of a Hip Hemi-Arthroplasty.

Gerontology 2020 May 26:1-8. Epub 2020 May 26.

Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology, and Immunology, Medical University of Vienna, Vienna, Austria.

Introduction: Muscle and bone metabolism are both important for the healing of fractures and the regeneration of injured muscle tissue. The aim of this investigation was to evaluate myostatin and other regulating factors in patients with hip fractures who underwent hemi-arthroplasty.

Methods: Serum levels of myostatin (MSTN), follistatin (FSTN), dickkopf-1 (Dkk1), and periostin (PSTN) as well as markers of bone turnover were evaluated in patients with hip fractures before surgery and twice in the 2 weeks after surgery. Read More

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http://dx.doi.org/10.1159/000507731DOI Listing

Constrained Liners Implanted Simultaneously at the Time of Acetabular Shell Revision with a Highly Porous Implant: Surprisingly Good Fixation at 10 Years.

J Bone Joint Surg Am 2020 May 25. Epub 2020 May 25.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.

Background: Many surgeons are reluctant to use a constrained liner at the time of acetabular component revision because of concerns that doing so might result in early acetabular component loosening related to high bone-implant interface stresses transmitted from the constrained liner. We hypothesized that, with appropriate initial implant stabilization using highly porous acetabular components with robust supplemental screw fixation, constrained liners could be safely used at the time of acetabular revision.

Methods: We retrospectively identified 148 revision total hip arthroplasties (THAs) in which a constrained liner of 1 design was cemented into a newly placed highly porous acetabular component fixed with supplemental screws (mean, 5 screws). Read More

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http://dx.doi.org/10.2106/JBJS.19.01332DOI Listing

Is Deep Learning On Par with Human Observers for Detection of Radiographically Visible and Occult Fractures of the Scaphoid?

Clin Orthop Relat Res 2020 May 19. Epub 2020 May 19.

D. W. G. Langerhuizen, S. J. Janssen, G. M. M. J. Kerkhoffs, Department of Orthopaedic Surgery, Amsterdam Movement Sciences (AMS), Amsterdam University Medical Centre, Amsterdam, The Netherlands A. E. J. Bulstra, R. L. Jaarsma, J. N. Doornberg, Flinders University, Department of Orthopaedic & Trauma Surgery, Flinders Medical Centre, Adelaide, Australia D. Ring, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA.

Background: Preliminary experience suggests that deep learning algorithms are nearly as good as humans in detecting common, displaced, and relatively obvious fractures (such as, distal radius or hip fractures). However, it is not known whether this also is true for subtle or relatively nondisplaced fractures that are often difficult to see on radiographs, such as scaphoid fractures.

Questions/purposes: (1) What is the diagnostic accuracy, sensitivity, and specificity of a deep learning algorithm in detecting radiographically visible and occult scaphoid fractures using four radiographic imaging views? (2) Does adding patient demographic (age and sex) information improve the diagnostic performance of the deep learning algorithm? (3) Are orthopaedic surgeons better at diagnostic accuracy, sensitivity, and specificity compared with deep learning? (4) What is the interobserver reliability among five human observers and between human consensus and deep learning algorithm?

Methods: We retrospectively searched the picture archiving and communication system (PACS) to identify 300 patients with a radiographic scaphoid series, until we had 150 fractures (127 visible on radiographs and 23 only visible on MRI) and 150 non-fractures with a corresponding CT or MRI as the reference standard for fracture diagnosis. Read More

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http://dx.doi.org/10.1097/CORR.0000000000001318DOI Listing

Intraoperative complications in total hip arthroplasty using a new cementless femoral implant (SP-CL).

J Orthop Traumatol 2020 May 25;21(1). Epub 2020 May 25.

Department of Traumatology and Orthopaedics, University of Tartu, Puusepa 8, Tartu, 51014, Estonia.

Background: Considering the excellent results already achieved in total hip arthroplasty (THA), new implants must be at least as safe as currently used implants and lead to longer survival. A new cementless femoral stem, SP-CL, has been introduced. The aim of this study is to evaluate intraoperative complications and assess the risk factors of THA with the SP-CL implant. Read More

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http://dx.doi.org/10.1186/s10195-020-00548-6DOI Listing

End-stage renal disease increases risk of postoperative complications after lower extremity fracture.

Arch Orthop Trauma Surg 2020 May 25. Epub 2020 May 25.

Harvard Orthopaedic Trauma Service, Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA, USA.

Introduction: End-stage renal disease (ESRD) leads to multiple systemic effects and patients suffer from multiple comorbidities including fractures. While previous studies have examined complications following hip fracture surgery in ESRD patients, there are no studies evaluating other lower extremity fractures. This study aimed to identify postoperative complication risk in patients with ESRD who had lower extremity fractures. Read More

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http://dx.doi.org/10.1007/s00402-020-03490-8DOI Listing

Cortical thinning and accumulation of large cortical pores in the tibia reflect local structural deterioration of the femoral neck.

Bone 2020 May 22:115446. Epub 2020 May 22.

Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. Electronic address:

Introduction: Cortical bone thinning and a rarefaction of the trabecular architecture represent possible causes of increased femoral neck (FN) fracture risk. Due to X-ray exposure limits, the bone microstructure is rarely measurable in the FN of subjects but can be assessed at the tibia. Here, we studied whether changes of the tibial cortical microstructure, which were previously reported to be associated with femur strength, are also associated with structural deteriorations of the femoral neck. Read More

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http://dx.doi.org/10.1016/j.bone.2020.115446DOI Listing

Management of Lower Extremity Fractures in the Elderly: A Focus on Post-Operative Rehabilitation.

Injury 2020 May 11. Epub 2020 May 11.

Sunnybrook Health Sciences Centre, Division of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada. Electronic address:

Fractures in the elderly population are increasing in incidence and represent a rising burden of disease. It is difficult for the elderly population to adhere to restricted weight bearing, and immobility poses significant risks and increased morbidity. Therefore, a primary goal of fracture management in the elderly population is early post-operative weight bearing. Read More

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http://dx.doi.org/10.1016/j.injury.2020.04.050DOI Listing

Anti-fracture Efficacy of Monthly Risedronate Compared with That of Weekly Risedronate in Postmenopausal Korean Women with Osteoporosis: A Nationwide Cohort Study.

Korean J Fam Med 2020 May 25. Epub 2020 May 25.

Department of Family Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea.

Background: Intermittent dosing regimens for oral risedronate (once-monthly and once-weekly) were developed for patient convenience. While several studies have reported the anti-fracture efficacy of weekly dosing, few have assessed monthly dosing. The lower efficacy of monthly dosing has been previously suggested. Read More

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http://dx.doi.org/10.4082/kjfm.19.0110DOI Listing

A systematic review and meta-analysis of vitamin D and calcium in preventing osteoporotic fractures.

Clin Rheumatol 2020 May 24. Epub 2020 May 24.

School of Sciences and Engineering, Pharmacy School, Pharmacoepidemiology-Pharmacovigilance, University of Nicosia, Makedonitissis 46, 2417, Nicosia, Cyprus.

To assess and update the effect of the combination of vitamin D and calcium in the reduction of osteoporotic fractures, a systematic review across Cochrane Database, NIHR HTA database, PubMed and Google Scholar was performed using mesh terms : Cohort studies OR Prospective Studies OR Longitudinal Studies OR Follow-Up Studies OR Incidence OR Risk OR Rate and Osteoporotic Fractures OR Fractures, Bone OR Fractures, Spontaneous OR Spinal Fractures OR Humeral Fractures OR Hip Fractures OR Femoral Neck Fractures AND Vitamin D AND Calcium and key words: vitamin D, fractures, osteoporosis, calcium, dietary supplements. Statistical analysis was performed with Review Manager (RevMan 5.3) using relative risk and confidence interval 95%. Read More

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http://dx.doi.org/10.1007/s10067-020-05122-3DOI Listing

Prevalence of asymptomatic radiographic vertebral fracture in postmenopausal Thai women.

Arch Osteoporos 2020 May 24;15(1):78. Epub 2020 May 24.

Menopausal Research Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

We aim to investigate the nationwide prevalence of asymptomatic radiographic vertebral fracture in Thailand. We found 29% of postmenopausal women had at least one radiographic vertebral fracture. The prevalence was significantly higher among women with osteoporosis at the total hip (TH) region which implies that TH bone mineral density is a determinant of vertebral fracture risk. Read More

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http://dx.doi.org/10.1007/s11657-020-00762-zDOI Listing

Evaluation of the use of anti-platelet therapy throughout the peri-operative period in patients with femoral neck fracture surgery. A retrospective cohort study.

Int Orthop 2020 May 24. Epub 2020 May 24.

Department of Surgery, College of Medicine, University of Kerbala, Kerbala, Iraq.

Introduction: Fracture neck of femur (hip fracture) is a very common problem among old age group. Such elderly patients usually have some comorbidities for which they may use anti-platelet therapy (such as clopidogrel, aspirin, or others) for long duration (chronic use). These anti-platelet medications might make the blood thin and increase bleeding tendency. Read More

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http://dx.doi.org/10.1007/s00264-020-04633-7DOI Listing

Strain shielding for cemented hip implants.

Clin Biomech (Bristol, Avon) 2020 May 15;77:105027. Epub 2020 May 15.

Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: Long-term survival of hip implants is of increasing relevance due to the rising life expectancy. The biomechanical effect of strain shielding as a result of implant insertion may lead to bone resorption, thus increasing risk for implant loosening and periprosthetic fractures. Patient-specific quantification of strain shielding could assist orthopedic surgeons in choosing the biomechanically most appropriate prosthesis. Read More

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http://dx.doi.org/10.1016/j.clinbiomech.2020.105027DOI Listing

Posterior dislocation of left hip joint with closed fracture of left acetabulum Judet-Letournel type posterior wall, femoral head fracture, management and follow up: A case report.

Int J Surg Case Rep 2020 May 8;71:85-90. Epub 2020 May 8.

Department of Orthopaedic & Traumatology, Cipto Mangunkusumo National Central Hospital and Faculty of Medicine, Universitas Indonesia, Jalan Diponegoro No. 71, Central Jakarta, Jakarta 10430, Indonesia.

Introduction: Traumatic dislocation of the hip is a very severe injury. Posterior hip dislocation can be associated with acetabular fracture, which can ultimately result in a higher incidence of complications.

Case Presentation: We present a case report of 26-year-old men with a motor vehicle accident and suffered a posterior hip dislocation on left hip joint and acetabular fracture with Judet-Letournel type posterior wall and femoral head fracture. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.04.009DOI Listing

Astaxanthin improves osteopenia caused by aldehyde-stress resulting from Aldh2 mutation due to impaired osteoblastogenesis.

Biochem Biophys Res Commun 2020 Jun 4;527(1):270-275. Epub 2020 May 4.

Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.

Aldehyde dehydrogenase 2 (ALDH2) plays major roles in aldehyde detoxification and in the catalysis of amino acids. ALDH2∗2, a dominant-negative transgenic expressing aldehyde dehydrogenase 2 (ALDH2) protein, is produced by a single nucleotide polymorphism (rs671) and is involved in the development of osteoporosis and hip fracture with aging. In a previous study, transgenic mice expressing Aldh2∗2(Aldh2∗2 Tg) osteoblastic cells or acetaldehyde -treated MC3T3-E1 showed impaired osteoblastogenesis and caused osteoporosis [1]. Read More

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http://dx.doi.org/10.1016/j.bbrc.2020.04.013DOI Listing

T-Score as an Indicator of Fracture Risk During Treatment With Romosozumab or Alendronate in the ARCH Trial.

J Bone Miner Res 2020 May 22. Epub 2020 May 22.

Service and Laboratory of Bone Diseases, Geneva University Hospital, Geneva, Switzerland.

In the Active-Controlled Fracture Study in Postmenopausal Women With Osteoporosis at High Risk (ARCH) clinical trial (NCT01631214), 1 year of romosozumab followed by alendronate reduced the risk of vertebral and nonvertebral fractures compared to alendronate alone in women with prevalent fracture. We performed post hoc analyses of data from patients in ARCH (romosozumab, n = 1739; alendronate, n = 1726) who had a baseline BMD measurement and received at least one open-label alendronate dose. We evaluated 1-year mean BMD and corresponding T-score changes; proportions of patients achieving T-scores > -2. Read More

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http://dx.doi.org/10.1002/jbmr.3996DOI Listing

Efficient predictors for the decline of activities of daily living in patients with hip fracture one year after surgery: A multicenter prospective cohort study.

J Back Musculoskelet Rehabil 2020 May 15. Epub 2020 May 15.

Department of Health Informatics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Background: Previous studies have examined when activities of daily living (ADL) recovery more than six months after surgery can be predicted, and how much accuracy the predictors have.

Objective: The purpose of this study was to determine the predictors of ADL decline and evaluate their accuracies one year post-operation for hip-fracture patients.

Methods: We studied patients who underwent hip fracture surgery and were able to walk independently pre-operatively. Read More

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http://dx.doi.org/10.3233/BMR-181126DOI Listing

Combined Malnutrition and Frailty Significantly Increases Complications and Mortality in Patient's Undergoing Elective Total Hip Arthroplasty.

J Arthroplasty 2020 Apr 21. Epub 2020 Apr 21.

Department of Orthopaedic Surgery, Atlanta, GA.

Background: The demand for total hip arthroplasty (THA) continues to rise. While prior work has examined frailty and malnutrition independently, the additive effects of these conditions are unknown. Therefore, the purpose of this study was to evaluate the individual and combined influence of malnutrition and frailty in the elective THA patient. Read More

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http://dx.doi.org/10.1016/j.arth.2020.04.028DOI Listing

Prevalence of frailty in China: Protocol for systematic review and meta-analysis.

Medicine (Baltimore) 2020 May;99(20):e20079

Gansu Provincial Hospital, Lanzhou, China.

Introduction: China is facing more and more enormous challenges including aging, the increase of social security costs and health care cost, decrease of labors, and how to keep elders' capacity to function well and live independently. Healthy aging has become an extremely challenging issue. Frailty, a geriatric syndrome resulted from the declines of multiple physiological systems, characterized by malnutrition, exercise intolerance, dependence, longer bed rest, lower gaits peed, weakness, weight loss, anorexia, hip fracture, risk of falling, delirium, dementia, and keep indoors, has become one of the biggest challenges in facilitating healthy aging. Read More

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http://dx.doi.org/10.1097/MD.0000000000020079DOI Listing

Analgesia for spinal anesthesia positioning in elderly patients with proximal femoral fractures: Dexmedetomidine-ketamine versus dexmedetomidine-fentanyl.

Medicine (Baltimore) 2020 May;99(20):e20001

Department of Anesthesiology and Pain Medicine, Inje University Haeundae Paik Hospital, Haeundaegu, Busan, Republic of Korea.

Elderly patients with femoral fractures are anticipated to endure the most pain caused by positional changes required for spinal anesthesia. To improve pain relief, we compared the analgesic effects of intravenous dexmedetomidine-ketamine and dexmedetomidine-fentanyl combinations to facilitate patient positioning for spinal anesthesia in elderly patients with proximal femoral fractures. Forty-six patients were randomly assigned to two groups and received either 1 mg/kg of intravenous ketamine (group K) or 1 μg/kg of intravenous fentanyl (group F) concomitant with a loading dose of dexmedetomidine 1 μg/kg over 10 minutes, then dexmedetomidine infusion only was continued at 0. Read More

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http://dx.doi.org/10.1097/MD.0000000000020001DOI Listing

Holistic Management of Older Patients With Hip Fractures.

Orthop Nurs 2020 May/Jun;39(3):183-191

Minh Ha Nguyen, MBBS, MRCP, is Consultant Geriatrician, Department of Older People's Health, Southern District Health Board, New Zealand. Siew Kwaon Lui, MBBS, MRCP, FAMS, is Consultant, Department of Rehabilitation Medicine, Singapore General Hospital, Singapore.

As the silver tsunami hits the world, older patients with hip fractures are expected to increase to 6.3 million by the year 2050, of which the majority will occur in Asia. The estimated global cost of hip fractures in the year 2050 is estimated to reach U. Read More

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http://dx.doi.org/10.1097/NOR.0000000000000656DOI Listing

Establishing a Geriatric Hip Fracture Program at a Level 1 Community Trauma Center.

Orthop Nurs 2020 May/Jun;39(3):171-179

Kristin O'Mara-Gardner, MSN, RN-BC, ONC, Geriatric Fracture Coordinator, ProMedica Toledo Hospital, Toledo, OH. Roberta E. Redfern, PhD, Research Scientist, ProMedica Toledo Hospital, Toledo, OH. Jeffrey M. Bair, MD, Orthopaedic Trauma Surgeon, ProMedica Toledo Hospital, Toledo, OH.

Background: Traditional care of patients with geriatric hip fracture has been fragmented with patients admitted under various specialty services and to different units within a hospital. This produces inconsistent care and leads to varying outcomes that can be associated with increased length of stay, delays in time from admission to surgery, and higher readmission rates.

Purpose: The purpose of this article is to describe the process taken to establish a successful geriatric hip fracture program (GFP) and the initial results observed in a single institution after its implementation. Read More

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http://dx.doi.org/10.1097/NOR.0000000000000655DOI Listing

Need and Rationale for Geriatric Fracture Programs.

Orthop Nurs 2020 May/Jun;39(3):162-164

Jennifer Sedlock, DNP, APRN, AGPCNP-BC, CFRN, is a board-certified adult gerontology nurse practitioner at Carle Foundation Hospital in Urbana, IL. Jaymie Green, MSN, RN, NE-BC, is a nurse manager for two inpatient surgical units at Carle Foundation Hospital in Urbana, IL. She is a boardcertified nurse executive with 13 years of orthopaedic and surgical experience. Lauren Diegel-Vacek, DNP, APRN, FNP-BC, CNE, is the Director of the DNP program at the University of Illinois at Chicago College of Nursing.

Fragility fractures among the older adult population are common, costly, and one of the top acute care facility diagnoses for this age group. Approximately 150,000 older adults in the United States are admitted to a hospital for treatment of a fragility hip fracture annually, with an estimated cost of more than $10 billion to the healthcare system. On admission to the hospital, patient treatment may be delayed, fragmented, or inadequate, adversely impacting length of stay and short- and long-term patient outcomes. Read More

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http://dx.doi.org/10.1097/NOR.0000000000000662DOI Listing

Pain Management with Early Regional Anesthesia in Geriatric Hip Fracture Patients.

J Am Geriatr Soc 2020 May 22. Epub 2020 May 22.

Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Background: Geriatric hip fracture patients are susceptible to the adverse effects of opioid-induced analgesia. Fascia iliaca blocks (FIBs) have emerged as an analgesic technique for this population. There are limited data on a preoperative FIB's effect on perioperative opioid intake. Read More

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http://dx.doi.org/10.1111/jgs.16547DOI Listing

Complications after internal screw fixation of nondisplaced femoral neck fractures in elderly patients: A systematic review.

Acta Orthop Traumatol Turc 2020 May 22. Epub 2020 May 22.

Department of Orthopaedics, Hanil General Hospital, Seoul, Korea.

Objective: Internal fixation with cannulated screws for nondisplaced femoral neck fractures in the elderly has substantial reoperation and mortality rates. The selection of either internal fixation or arthroplasty for nondisplaced femoral neck fracture is debatable.

Methods: We performed a systematic review of the literature regarding complications in the internal fixation of nondisplaced femoral neck fractures in elderly (>60 years old) patients. Read More

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http://dx.doi.org/10.5152/j.aott.2020.03.113DOI Listing

Postoperative atrial fibrillation is related to a worse outcome in patients undergoing surgery for hip fracture.

Intern Emerg Med 2020 May 21. Epub 2020 May 21.

Dipartimento Medicina Sperimentale e Clinica, Università Di Firenze, Viale Morgagni 85, 50134, Florence, Italy.

Few information exist about incidence and prognostic significance of postoperative atrial fibrillation (POAF) in patients undergoing hip fracture surgery. In the period comprised between January 2012 and December 2016, we evaluated 3129 patients referred for hip fracture. At hospital admission 277 were in permanent atrial fibrillation and were excluded from the study. Read More

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http://dx.doi.org/10.1007/s11739-020-02372-6DOI Listing

Trabecular bone score in patients with chronic kidney disease.

Osteoporos Int 2020 May 21. Epub 2020 May 21.

Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada.

Patients with chronic kidney disease have high risk of osteoporotic fractures. Lower trabecular bone score (TBS) was associated with poorer kidney function and higher fracture risk when kidney function was normal. Addition of TBS to The Fracture Risk Assessment Tool with bone mineral density did not improve fracture risk prediction. Read More

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http://dx.doi.org/10.1007/s00198-020-05458-1DOI Listing

Association of preoperative medication with postoperative length of stay in elderly patients undergoing hip fracture surgery.

Aging Clin Exp Res 2020 May 21. Epub 2020 May 21.

Department of Pharmacy, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun Street, Xicheng District, Beijing, 100053, China.

Background: For elderly patients who are about to undergo surgery, research on the effects of preoperative medication on postoperative outcomes is rare, especially preoperative discontinuation-requiring medication (PDRM) which needed to be discontinued because of its increased risk of postoperative complications.

Aim: To investigate whether preoperative medication (PDRM and polypharmacy) is associated with postoperative length of hospital stay (LOS) in elderly patients undergoing hip fracture surgery.

Methods: Patients aged ≥ 65 who were scheduled for hip (limited to femoral tuberosity) fracture surgery were included. Read More

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http://dx.doi.org/10.1007/s40520-020-01567-3DOI Listing

The efficacy and safety of denosumab in postmenopausal women with osteoporosis previously treated with bisphosphonates: A review.

J Orthop Translat 2020 May 9;22:7-13. Epub 2019 Sep 9.

Department of Orthopaedics, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.

Objective: The objective of this study was to assess the efficacy and safety of denosumab therapy in osteoporotic postmenopausal women who were previously treated with bisphosphonates.

Methods: Meta-analyses of four available randomised controlled trials that compared osteoporotic patients who switched to denosumab from bisphosphonates (n ​= ​1416) and those who continued bisphosphonates therapy (n ​= ​1411) were included.

Results: The increase in bone mineral density (BMD) of both the spine and hip was significantly higher in patients who shifted to denosumab than in those who continued bisphosphonates. Read More

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http://dx.doi.org/10.1016/j.jot.2019.08.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231967PMC

Compliance with national guidelines for antibiotic prophylaxis in hip fracture patients: a quality assessment study of 13 329 patients in the Norwegian Hip Fracture Register.

BMJ Open 2020 May 20;10(5):e035598. Epub 2020 May 20.

Orthopaedic Department, Baerum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway.

Objective: We assessed compliance with new guidelines for prophylactic antibiotics in hip fracture surgery in Norway introduced in 2013.

Design: The data from the Norwegian Hip Fracture Register was used to assess the proportion of antibiotics given according to the national guidelines.

Setting: All hospitals in Norway performing hip fracture surgery in the period from 2011 to 2016. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-035598DOI Listing

The identification of adverse events in hip fracture patients using the Global Trigger Tool: A prospective observational cohort study.

Int J Orthop Trauma Nurs 2020 Apr 22:100779. Epub 2020 Apr 22.

Acute and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.

Introduction: Hip fracture is common in the elderly and is associated with high comorbidity, mortality and complication rates. There has been an increase in the investigation of healthcare-related adverse events (AEs) in some patient groups but there is limited knowledge about hip fracture patients. The aim was to explore the incidence, preventability and nature of AEs in hip fracture patients. Read More

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http://dx.doi.org/10.1016/j.ijotn.2020.100779DOI Listing

Artificial Neural Network and Cox Regression Models for Predicting Mortality after Hip Fracture Surgery: A Population-Based Comparison.

Medicina (Kaunas) 2020 May 19;56(5). Epub 2020 May 19.

Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.

This study purposed to validate the accuracy of an artificial neural network (ANN) model for predicting the mortality after hip fracture surgery during the study period, and to compare performance indices between the ANN model and a Cox regression model. A total of 10,534 hip fracture surgery patients during 1996-2010 were recruited in the study. Three datasets were used: a training dataset ( = 7,374) was used for model development, a testing dataset ( = 1,580) was used for internal validation, and a validation dataset (1580) was used for external validation. Read More

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http://dx.doi.org/10.3390/medicina56050243DOI Listing

Retrospective analysis of eligibility for denosumab in patients presenting with osteoporotic fractures and renal impairment treated by orthogeriatric service at Middlemore Hospital.

N Z Med J 2020 May 22;133(1515):16-24. Epub 2020 May 22.

Consultant Orthogeriatrician, ARHOP, Counties Manukau Health, Auckland.

Background: Little is known about the prevalence of renal impairment in patients presenting with osteoporotic fractures contraindicating bisphosphonate use in New Zealand, and their eligibility to denosumab.

Aim: To assess the prevalence of renal impairment contraindicating bisphosphonate use in older adults presenting with osteoporotic fractures, differences in demographic variables between those with renal impairment and those who do not, and finally to assess eligibility for denosumab based on the current PHARMAC special authority criteria.

Method: All patients 65 years and older with osteoporotic fractures treated by inpatient orthogeriatric service (IOS) and the outpatient fracture liaison service (FLS) at Middlemore Hospital between 1 February to 31 April 2019 were assessed. Read More

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History of alendronate.

Bone 2020 May 10:115411. Epub 2020 May 10.

Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK; Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK.

Alendronate was synthesized in 1970s in a search for inhibitors of calcification. Istituto Gentili investigators identified it as a potent inhibitor of bone resorption and obtained a patent covering its use in the treatment of osteoporosis and other disorders of excessive bone resorption in the 1980s. Merck licensed alendronate in 1988 and its pharmaceutical chemists reformulated it as a sodium salt with good solubility in a tablet that reduced its potential for esophageal irritation. Read More

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http://dx.doi.org/10.1016/j.bone.2020.115411DOI Listing

Effect on mortality of treatment method and surgery time for hip fracture patients aged over 65 years.

Ulus Travma Acil Cerrahi Derg 2020 May;26(3):439-444

Department of Orthopaedics and Traumatology, Cumhuriyet University Faculty of Medicine, Sivas-Turkey.

Background: This study aimed to evaluate the effects on mortality of implant selection used and time to surgery in patients aged over 65 years operated for hip fractures.

Methods: A total of 301 patients aged over 65 years were investigated in this study. Patients were divided into three groups as follows: Group 1 cemented hemiarthroplasty (CH), Group 2 cementless hemiarthroplasty (CLH), and Group 3 proximal femoral nail (PFN). Read More

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http://dx.doi.org/10.14744/tjtes.2020.81780DOI Listing

Is it safe to do a single-stage implant exit and primary hip replacement? clinical and microbiological profiling.

Indian J Med Microbiol 2019 Oct-Dec;37(4):531-535

Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India.

Background: A single-stage implant revision for failed fixation of proximal femoral fractures is performed only when there is no evidence of infection. Else, a two-staged revision is preferred - where the definitive revision surgery is done a few months after the implant exit. This study aims to audit the safety and incidence of culture positivity in single-stage revisions. Read More

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http://dx.doi.org/10.4103/ijmm.IJMM_20_40DOI Listing

Microbiological profile of infections of the hip joint: An Indian perspective.

Indian J Med Microbiol 2019 Oct-Dec;37(4):509-513

Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India.

Background: Knowledge of the local microbiological epidemiology helps in formulating protocols for appropriate treatment of hip infections. The aim of this study was to profile the organisms cultured from infected hips.

Methods: The microbiological profile and sensitivity pattern of organisms in eighty infected hips were reviewed. Read More

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http://dx.doi.org/10.4103/ijmm.IJMM_20_31DOI Listing

Economic burden of osteoporotic fractures in US managed care enrollees.

Am J Manag Care 2020 May 1;26(5):e142-e149. Epub 2020 May 1.

Radius Health, Inc, 550 E Swedesford Rd, Ste 370, Wayne, PA 19087. Email:

Objectives: To examine healthcare resource utilization (HRU) and costs in a population of managed care enrollees who experienced an osteoporotic fracture.

Study Design: Retrospective cohort study using the Optum Research Database (January 2007 to May 2017).

Methods: All-cause and osteoporosis-related HRU and costs were analyzed in patients 50 years and older with a qualifying index fracture and continuous enrollment with medical and pharmacy benefits for 12 months preindex (baseline period). Read More

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http://dx.doi.org/10.37765/ajmc.2020.43156DOI Listing