title: Alendronate and raloxifene therapy in the early period after hip fracture.
abstract: OBJECTIVE
  The purpose of the present study was to clarify the efficacy of alendronate and raloxifene for preventing bone loss in patients with hip fracture by monitoring bone mineral densities (BMDs) and biochemical markers during the 9-month period after fracture.
  
  
  METHODS
  Eighty-two female hip fracture patients from 50 to 99 years old (mean ± SD: 81.6 ± 9.5) were randomly divided into two groups; there were 46 patients in the alendronate-treated group (group ALN) and 36 patients in the raloxifene-treated group (group RLX). Drugs were administered to patients six weeks after their operations. Lumbar spine BMD and neck, trochanter, Ward's and total BMDs of the contralateral proximal femur, serum intact osteocalcin (intact OC), bone-specific alkaline phosphatase (BAP) and urinary N-terminal telopeptide of type I collagen (NTX) were measured just before the start of drug administration and at 9 months thereafter.
  
  
  RESULTS
  Twenty-two out of 46 patients in group ALN and 23 out of 36 patients in group RLX completed the study. The most common reason for dropping out was the patient's failure to visit the outpatient clinic. Trochanter BMD in group ALN tended to increase by 8.4% compared with the baseline, and total hip BMD in group RLX showed a significant increase (5.7%), although neck BMD in both groups decreased during the 9 months of treatment (-8.7% for group ALN and -4.2% for group RLX compared with the baseline). Spine BMD did not change significantly in eithr group. Serum BAP and urinary NTX decreased significantly in both groups. Serum intact OC did not change significantly.
  
  
  CONCLUSIONS
  Both alendronate and raloxifene have a favorable effect on trochanter and total BMDs of the contralateral proximal femur in the short period after hip fracture. However, both drugs could not prevent bone loss in the femoral neck during the 9 months of treatment.
authors: Department of Orthopaedic Surgery, Enshu Hospital, Japan.
authors: Tsuyoshi
authors: T
authors: Ohishi
authors: Department of Orthopaedic Surgery, Narita Memorial Hospital, Japan.
authors: Tetsuya
authors: T
authors: Ichikawa
authors: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Japan.
authors: Takanori
authors: T
authors: Ito
authors: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Japan.
authors: Hiroshi
authors: H
authors: Koyama
authors: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Japan.
authors: Michihito
authors: M
authors: Miyagi
authors: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Japan.
authors: Hironobu
authors: H
authors: Hoshino
authors: Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Japan.
authors: Masaaki
authors: M
authors: Takahashi
keywords: alendronate; bone mineral density; dropout; hip fracture; raloxifene
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