EFFECT OF BISPHOSPHONATE THERAPY ON FUNCTIONAL OUTCOMES AND FRACTURE HEALING IN OSTEOPOROTIC HIP FRACTURES: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background: Osteoporosis-related hip fractures represent a major burden in orthopedic practice. While bisphosphonates are established in preventing secondary fractures, their effect on fracture healing and postoperative outcomes remains debated.

Objective: To evaluate the role of early bisphosphonate therapy on radiological union, functional recovery, and prevention of subsequent fractures in elderly patients with osteoporotic hip fractures.
Methods: A prospective study was conducted on 120 patients (>60 years) with low-energy osteoporotic hip fractures treated surgically. Patients were divided into two groups: Group A (n=60) received standard care plus bisphosphonate therapy (oral alendronate 70 mg/week or IV zoledronic acid 5 mg yearly), while Group B (n=60) received standard care only. Outcomes assessed included time to radiological union, Harris Hip Score (HHS), pain score (VAS), and incidence

of new fragility fractures at 12 months.

Results: Mean union time was comparable (Group A: 15.8 ± 2.1 weeks; Group B: 16.2 ± 2.4 weeks; p=0.41). Functional outcomes were superior in Group A with higher HHS at 6 months (78.5 ± 8.2 vs 72.3 ± 9.1, p=0.02) and 12 months (85.4 ± 7.5 vs 79.1 ± 8.7, p=0.01). New fragility fractures occurred in 3.3% of Group A vs 13.3% of Group B (p=0.04). No significant increase in delayed union or nonunion was observed with bisphosphonate therapy.

Conclusion: Early initiation of bisphosphonate therapy following osteoporotic hip fracture surgery improves functional recovery and reduces the risk of subsequent fractures without adversely affecting fracture healing.