Initiation of Monthly Minodronate Therapy at an Early Stage After Hip Fracture

Abstract

The incidence of second hip fractures occurring within a year of initial fractures is 20%–45%. The high incidence of second hip fractures in this period can be attributed to the rapid bone loss that occurs during this time. Restoring bone mass at an early stage after hip fractures is critical for preventing subsequent fractures. The aim of this study was to investigate the efficacy of monthly minodronate therapy (50 mg/4 wk) for preventing bone loss over a 9-mo period following hip fractures. Minodronate was administered monthly to 51 patients (44 females), beginning within 3 mo after hip fracture surgery. The mean (±standard deviation) age of the patients was 82.0 ± 0.9 yr. Demographics, mobility status, bone turnover makers, and bone mineral density (BMD) in the lumbar spine and proximal femur (including femoral neck and total hip BMD) were examined prior to and after 9 mo of treatment. Lumbar BMD was increased by 2.7% ± 4.4% (p < 0.001) compared to the baseline values. However, femoral neck and total hip BMD did not significantly change. Bone formation and resorption markers both decreased by approximately 70% during treatment. Monthly treatment with minodronate did not adversely affect the healing process on the fracture site or the patients' laboratory results. The patients who were independently mobile prior to injury exhibited greater recovery of BMD in the femoral neck during the 9-mo treatment period. Monthly minodronate therapy during the early stages after hip fractures has favorable effects on restoring overall lumbar BMD and contralateral femoral neck BMD in patients with independent mobility prior to fractures.