title: Enhancement of hip fracture healing in the elderly: Evidence deriving from a pilot randomized trial.
abstract: Enhancement of healing of osteoporotic fractures remains a significant objective of contemporary clinical care. Aiming to produce preliminary clinical evidence on the effect of antiosteoporotic drugs on the process of fragility fracture healing, a pilot prospective randomized assessor-blinded trial was performed. The tested hypothesis was that it is possible to accelerate the healing of hip fractures in the presence of osteoporosis with the administration of therapeutic agents. However, significant difficulties of recruitment and completion of follow up did not allow the researchers to produce the preliminary evidence testing the study hypothesis, highlighting the challenges that contemporary clinical investigators face when conducting studies focusing on elderly patients, with high proportion of coinciding factors affecting patients' eligibility, compliance, and overall outcome. Nevertheless, the significance of enhancing bone healing in this specific patient population, dictates further clinical efforts and future well designed and funded trials of adequate power and level of evidence are desirable to allow the effective and safer management of the consequences of the modern epidemic of osteoporosis.
authors.affiliation: Clinical Lead Major Trauma Service, Consultant Trauma and Orthopaedics, Leeds Teaching Hospitals NHS Trust, School of Medicine, University of Leeds, United Kingdom. Electronic address: n.kanakaris@nhs.net.
authors.forename: Nikolaos K
authors.initials: NK
authors.lastname: Kanakaris
authors.affiliation: Leeds Institute of Health Sciences, University of Leeds, United Kingdom. Electronic address: r.m.west@leeds.ac.uk.
authors.forename: Robert M
authors.initials: RM
authors.lastname: West
authors.affiliation: Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals NHS Trust, School of Medicine, University of Leeds, United Kingdom. Electronic address: pgiannoudi@aol.com.
authors.forename: Peter V
authors.initials: PV
authors.lastname: Giannoudis
mesh_terms: D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001842:Bone and Bones / Q000187:drug effects* / Q000473:pathology; D005260:Female; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000187:drug effects*; D016330:Frail Elderly; D006620:Hip Fractures / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy*; D058866:Osteoporotic Fractures / Q000188:drug therapy / Q000473:pathology / Q000517:prevention & control*; D010865:Pilot Projects; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D050071:Bone Density Conservation Agents
keywords: Antiosteoporotic therapy; Fragility fracture; Hip fracture; NOF; Osteoporosis; Prospective randomized trial