Anabolic Steroids Improve Bone Mineral Density and Quality of Life in Patients with Osteoporotic Fractures Around the Hip

Abstract

AIM: Osteoporotic fractures cause considerable morbidity and disability in both women and men. The current prospective study was designed to identify the effect of anabolic steroids in patients with osteoporotic fractures around the hip. METHODS: A total of 248 patients with unilateral osteoporotic hip fractures (t≤-2.5, as measured by a DEXA of the contra-lateral hip) were included in the study and divided into two groups randomly. Group 1 comprising of 132 patients, was given Nandrolone 50 milligrams once a week for 5 weeks, along with 500 mg of elemental calcium and 0.25 micrograms of calcitriol once daily for 3 months, starting from the next day of surgery. Group 2 comprising of 116 patients was given only 500 mg of elemental calcium and 0.25 micrograms of calcitriol once daily for 3 months from the first post operative day. In group 1 eight patients expired and 24 were lost to follow up, leaving a total of 100 patients at the final follow up of 1 year; while in group 2 ten expired and 20 were lost to follow up leaving a total of 86 at final follow up. The patients were evaluated at 3, 6 and 12 months for BMD, Katz index for activities of daily living and functional improvement. RESULTS: In Group 1 it was observed that the mean t-score improved from -2.9160.573 at presentation to -2.112±0.599 at 12 months. The mean Harris Hip Score was 85.44±10.56 and the Katz index of independence in activities of daily living showed marked improvement. The patients of group 2 showed less marked improvement in their mean t-scores as well as the mean Harris hip score and the Katz index. CONCLUSION: The current study suggests that the use of low dose anabolic steroids results in a significant gain in bone mass and improvement in quality of life in geriatric population, but comparative studies with a larger sample size and longer follow up are required to further support this observation.