Time Is Bone: Missed Opportunities for Secondary Prevention After a Hip Fracture

Area of Science:

• Geriatric Medicine
• Orthopedic Surgery
• Public Health

Background:

• Secondary fracture prevention is critical after hip fractures in the elderly.
• Osteoporosis management following hip fracture requires early evaluation and treatment.
• Current documentation of osteoporosis management in hip fracture studies is unclear.

Purpose of the Study:

• To systematically review and summarize the reporting of osteoporosis management in studies of operatively treated hip fractures in elderly patients.
• To identify gaps in the documentation of secondary fracture prevention strategies.
• To provide recommendations for clinical practice and future research.

Main Methods:

• Systematic review adhering to PRISMA guidelines.
• Comprehensive literature search across major databases (PubMed, Embase, Cochrane, Web of Science, Ovid) within the last decade.
• Inclusion of studies on operatively treated hip fractures in patients >65 years, with independent screening and data extraction by two reviewers.

Main Results:

• Eighty-six articles were included in the review.
• Osteoporosis management was reported in only 12 (14%) of the included studies.
• Only six studies (7%) were from institutions with established orthogeriatric care.

Conclusions:

• Osteoporosis management is significantly underreported in studies of operatively treated hip fractures in elderly individuals.
• This underreporting indicates a substantial gap in the documentation of secondary fracture prevention efforts.
• There is a need for increased clinical vigilance in managing osteoporosis post-hip fracture and for research focused on the effectiveness of secondary prevention strategies.