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

Background/

Objectives

Early evaluation and treatment of osteoporosis following a hip fracture is of paramount importance for secondary fracture prevention. Nevertheless, the extent to which osteoporosis management is documented in studies reporting on operatively treated hip fractures in elderly patients is unclear. This study is the first systematic review aiming to investigate and summarize the reporting of osteoporosis management in studies with operatively treated hip fractures in elderly patients.

Methods

This systematic review was conducted in compliance with PRISMA guidelines. A comprehensive search within the last decade of PubMed, Embase, Cochrane Library, Web of Science, and Ovid was performed. Studies reporting on operatively treated hip fractures in patients older than 65 years of age were included. Two reviewers independently screened the studies and performed data extraction. A subsequent descriptive synthesis was performed.

Results

Eighty-six (86) articles were included in this study. Osteoporosis management was reported in only twelve (12) studies. Only six (6) of them were conducted in institutions with established orthogeriatric care.

Conclusions

Osteoporosis management is underreported in studies involving operatively treated hip fracture patients. This reflects a significant gap in the overall reporting of secondary fracture prevention actions. Consequently, we advocate for both (a) clinical vigilance for adherence to best practice related to osteoporosis management after the first hip fracture and reporting of the results and (b) the research focusing on the outcomes of secondary fracture prevention efforts.