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Early bisphosphonate therapy post proximal femoral fracture fixation does not impact fracture healing: a systematic review and meta‐analysis
BACKGROUND: There is conjecture on the optimal timing to administer bisphosphonate therapy following operative fixation of low‐trauma hip fractures. Factors include recommendations for early opportunistic commencement of osteoporosis treatment, and clinician concern regarding the effect of bisphosph...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons Australia, Ltd
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796623/ https://www.ncbi.nlm.nih.gov/pubmed/35655397 http://dx.doi.org/10.1111/ans.17792 |
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author | Tong, Yui Yee Felice Holmes, Samuel Sefton, Andrew |
author_facet | Tong, Yui Yee Felice Holmes, Samuel Sefton, Andrew |
author_sort | Tong, Yui Yee Felice |
collection | PubMed |
description | BACKGROUND: There is conjecture on the optimal timing to administer bisphosphonate therapy following operative fixation of low‐trauma hip fractures. Factors include recommendations for early opportunistic commencement of osteoporosis treatment, and clinician concern regarding the effect of bisphosphonates on fracture healing. We performed a systematic review and meta‐analysis to determine if early administration of bisphosphonate therapy within the first month post‐operatively following proximal femur fracture fixation is associated with delay in fracture healing or rates of delayed or non‐union. METHODS: We included randomized controlled trials examining fracture healing and union rates in adults with proximal femoral fractures undergoing osteosynthesis fixation methods and administered bisphosphonates within 1 month of operation with a control group. Data were pooled in meta‐analyses where possible. The Cochrane Risk of Bias Tool and the GRADE approach were used to assess validity. RESULTS: For the outcome of time to fracture union, meta‐analysis of three studies (n = 233) found evidence for earlier average time to union for patients receiving early bisphosphonate intervention (MD = −1.06 weeks, 95% CI −2.01–−0.12, I(2) = 8%). There was no evidence from two included studies comprising 718 patients of any difference in rates of delayed union (RR 0.61, 95% CI 0.25–1.46). Meta‐analyses did not demonstrate a difference in outcomes of mortality, function or pain. CONCLUSIONS: We provide low‐level evidence that there is no reduction in time to healing or delay in bony union for patients receiving bisphosphonates within 1 month of proximal femur fixation. |
format | Online Article Text |
id | pubmed-9796623 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley & Sons Australia, Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-97966232022-12-30 Early bisphosphonate therapy post proximal femoral fracture fixation does not impact fracture healing: a systematic review and meta‐analysis Tong, Yui Yee Felice Holmes, Samuel Sefton, Andrew ANZ J Surg Review Articles BACKGROUND: There is conjecture on the optimal timing to administer bisphosphonate therapy following operative fixation of low‐trauma hip fractures. Factors include recommendations for early opportunistic commencement of osteoporosis treatment, and clinician concern regarding the effect of bisphosphonates on fracture healing. We performed a systematic review and meta‐analysis to determine if early administration of bisphosphonate therapy within the first month post‐operatively following proximal femur fracture fixation is associated with delay in fracture healing or rates of delayed or non‐union. METHODS: We included randomized controlled trials examining fracture healing and union rates in adults with proximal femoral fractures undergoing osteosynthesis fixation methods and administered bisphosphonates within 1 month of operation with a control group. Data were pooled in meta‐analyses where possible. The Cochrane Risk of Bias Tool and the GRADE approach were used to assess validity. RESULTS: For the outcome of time to fracture union, meta‐analysis of three studies (n = 233) found evidence for earlier average time to union for patients receiving early bisphosphonate intervention (MD = −1.06 weeks, 95% CI −2.01–−0.12, I(2) = 8%). There was no evidence from two included studies comprising 718 patients of any difference in rates of delayed union (RR 0.61, 95% CI 0.25–1.46). Meta‐analyses did not demonstrate a difference in outcomes of mortality, function or pain. CONCLUSIONS: We provide low‐level evidence that there is no reduction in time to healing or delay in bony union for patients receiving bisphosphonates within 1 month of proximal femur fixation. John Wiley & Sons Australia, Ltd 2022-06-02 2022-11 /pmc/articles/PMC9796623/ /pubmed/35655397 http://dx.doi.org/10.1111/ans.17792 Text en © 2022 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Review Articles Tong, Yui Yee Felice Holmes, Samuel Sefton, Andrew Early bisphosphonate therapy post proximal femoral fracture fixation does not impact fracture healing: a systematic review and meta‐analysis |
title | Early bisphosphonate therapy post proximal femoral fracture fixation does not impact fracture healing: a systematic review and meta‐analysis |
title_full | Early bisphosphonate therapy post proximal femoral fracture fixation does not impact fracture healing: a systematic review and meta‐analysis |
title_fullStr | Early bisphosphonate therapy post proximal femoral fracture fixation does not impact fracture healing: a systematic review and meta‐analysis |
title_full_unstemmed | Early bisphosphonate therapy post proximal femoral fracture fixation does not impact fracture healing: a systematic review and meta‐analysis |
title_short | Early bisphosphonate therapy post proximal femoral fracture fixation does not impact fracture healing: a systematic review and meta‐analysis |
title_sort | early bisphosphonate therapy post proximal femoral fracture fixation does not impact fracture healing: a systematic review and meta‐analysis |
topic | Review Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9796623/ https://www.ncbi.nlm.nih.gov/pubmed/35655397 http://dx.doi.org/10.1111/ans.17792 |
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