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Women with hip fracture experience greater loss of geometric strength in the contralateral hip during the year following fracture than age-matched controls

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Abstract

Summary

This study examined femur geometry underlying previously observed decline in BMD of the contralateral hip in older women the year following hip fracture compared to non-fractured controls. Compared to controls, these women experienced a greater decline in indices of bone structural strength, potentially increasing the risk of a second fracture.

Introduction

This study examined the femur geometry underlying previously observed decline in BMD of the contralateral hip in the year following hip fracture compared to non-fractured controls.

Methods

Geometry was derived from dual-energy X-ray absorptiometry scan images using hip structural analysis from women in the third cohort of the Baltimore Hip Studies and from women in the Study of Osteoporotic Fractures. Change in BMD, section modulus (SM), cross-sectional area (CSA), outer diameter, and buckling ratio (BR) at the narrow neck (NN), intertrochanteric (IT), and shaft (S) regions of the hip were compared.

Results

Wider bones and reduced CSA underlie the significantly lower BMD observed in women who fractured their hip resulting in more fragile bones expressed by a lower SM and higher BR. Compared to controls, these women experienced a significantly greater decline in CSA (−2.3% vs. −0.2%NN, −3.2% vs. −0.5%IT), SM (−2.1% vs. −0.2%NN, −3.9% vs. −0.6%IT), and BMD (−3.0% vs. −0.8%NN, −3.3% vs. −0.6%IT, −2.3% vs. −0.2%S) and a greater increase in BR (5.0% vs. 2.1%NN, 6.0% vs. 1.3%IT, 4.4% vs. 1.0%S) and shaft outer diameter (0.9% vs. 0.1%).

Conclusion

The contralateral femur continued to weaken during the year following fracture, potentially increasing the risk of a second fracture.

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Conflicts of interest

The lead author has no conflicts of interest to report.

The following co-authors report disclosures for:

Consultancies: J. Magaziner—Merck, Novartis, Amgen; M.C. Hochberg—Amgen, Merck, Novartis, Roche Pharmaceutical Co., Wyeth Pharmaceuticals, and Eli Lilly Inc. In neither case do the consultancies relate to the research presented in this paper.

Licensing arrangement: T.J. Beck—the HSA method has been licensed to Hologic Inc. by the Johns Hopkins University, employer of T.J. Beck.

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Authors and Affiliations

  1. Johns Hopkins University Bloomberg School of Public Health, 624 N. Broadway Room 698, Baltimore, MD, 21205, USA

    L. Reider & T. J. Beck

  2. University of Maryland, Baltimore, MD, USA

    M. C. Hochberg, W. G. Hawkes, D. Orwig, J. R. Hebel & J. Magaziner

  3. Union Memorial Hospital, Baltimore, MD, USA

    J. A. YuYahiro

Authors
  1. L. Reider
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  2. T. J. Beck
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  3. M. C. Hochberg
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  4. W. G. Hawkes
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  5. D. Orwig
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  6. J. A. YuYahiro
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  7. J. R. Hebel
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  8. J. Magaziner
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for the Study of Osteoporotic Fractures Research Group

Corresponding author

Correspondence to L. Reider.

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Funding Sources

The Study of Osteoporotic Fractures (SOF) is supported by National Institutes of Health funding. The National Institute on Aging (NIA) provides support under the following grant numbers: AG05407, AR35582, AG05394, AR35584, AR35583, R01 AG005407, R01 AG027576-22, 2 R01 AG005394-22A1, and 2 R01 AG027574-22A1, AG05407, AR35582, AG05394, AR35584, AR35583, AG026720.

The Baltimore Hip Studies are supported by NIH grant numbers: R37 AG009901; R01 AG018668; P30 AG028747.

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Reider, L., Beck, T.J., Hochberg, M.C. 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 21, 741–750 (2010). https://doi.org/10.1007/s00198-009-1000-4

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  • DOI: https://doi.org/10.1007/s00198-009-1000-4

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