Osteoporosis International

, Volume 21, Issue 5, pp 741–750

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

  • L. Reider
  • T. J. Beck
  • M. C. Hochberg
  • W. G. Hawkes
  • D. Orwig
  • J. A. YuYahiro
  • J. R. Hebel
  • J. Magaziner
  • for the Study of Osteoporotic Fractures Research Group
Original Article

DOI: 10.1007/s00198-009-1000-4

Cite this article as:
Reider, L., Beck, T.J., Hochberg, M.C. et al. Osteoporos Int (2010) 21: 741. doi:10.1007/s00198-009-1000-4

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.

Keywords

Bone geometry Hip fracture Trends in geometry following hip fracture 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2009

Authors and Affiliations

  • L. Reider
    • 1
  • T. J. Beck
    • 1
  • M. C. Hochberg
    • 2
  • W. G. Hawkes
    • 2
  • D. Orwig
    • 2
  • J. A. YuYahiro
    • 3
  • J. R. Hebel
    • 2
  • J. Magaziner
    • 2
  • for the Study of Osteoporotic Fractures Research Group
  1. 1.Johns Hopkins University Bloomberg School of Public HealthBaltimoreUSA
  2. 2.University of MarylandBaltimoreUSA
  3. 3.Union Memorial HospitalBaltimoreUSA