title: Osteosynthetic improvement of osteoporotic bone: prevention surgery.
abstract: A prior osteoporotic femoral neck fracture (FNF) doubles the risk of a second, contralateral hip fracture. Pharmacological prevention of osteoporotic fractures is cost-effective but medication compliance and persistence rates are suboptimal.The aim of our study was to evaluate the safety and effectiveness of a device developed for the surgical prevention of an additional contralateral FNF in elderly osteoporotic patients.Only patients with a T score ≤ -2.5 were enrolled and randomized either to receive (Group A) or not receive (Group B) surgical prevention. Sixty-seven patients were enrolled. The mean follow-up was 16 months (range 1 to 22). To date, no contralateral FNF has been reported in either group. In Group A, no device-related complications were recorded. Twelve patients reported one or more falls and in four cases a non-femoral fragility fracture occurred.The main problem with pharmacological prevention is therapy adherence and the extensive period needed for only a slight improvement in bone strength.Surgical prevention is a potential solution for avoiding the occurrence of a second contralateral FNF. Nevertheless, a longer follow-up and a larger cohort of patients is necessary in order to verify the true effectiveness of the surgical prevention in elderly osteoporotic patients.
authors.affiliation: II Orthopaedics and Trauma Clinic - Rizzoli Orthopaedic Institute - University of Bologna, Bologna, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Giannini
authors.forename: Deianira
authors.initials: D
authors.lastname: Luciani
authors.forename: Eugenio
authors.initials: E
authors.lastname: Chiarello
authors.forename: Matteo
authors.initials: M
authors.lastname: Cadossi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tedesco
authors.forename: Martha
authors.initials: M
authors.lastname: Hoque
authors.forename: Saverio
authors.initials: S
authors.lastname: Gnudi