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Query: UNIPROT:P50502 (Hip)
 7,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hip fracture is costly from both personal and public health perspectives. Major advances in understanding the risk factors for osteoporotic fracture and in developing strategies to reduce risk have occurred in recent years. Effective interventions to reduce hip fracture risk include vitamin D and calcium supplementation, antiresorptive agents such as bisphosphonates and possibly estrogen and the anabolic agent teriparatide, fall prevention strategies, and use of hip protectors. Current clinical practice regarding hip fracture prevention, however, leaves much to be desired. Primary care physicians seeing high-risk patients must identify and manage this risk. Radiologists, orthopedic surgeons, and rehabilitation medicine physicians who diagnose and treat patients for fracture-a major risk factor for subsequent fracture-must refer patients for additional assessment and treatment to reduce risk. Appropriate risk factor assessment and use of current intervention strategies should markedly reduce the numbers of new fractures.
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PMID:Patients with hip fracture: what can be improved? 1640 48

Incidence of a fracture, particularly in the hip joint, is high in elderly women with Parkinson's disease (PD), and this is due to the immobilization-induced bone resorption and vitamin D deficiency with reduced bone mineral density (BMD). The objective of this study was to address the possibility that treatment with alendronate and vitamin D2 may reduce the incidence of hip fractures in elderly women with PD. PD patients were randomly assigned to daily treatment with 5 mg alendronate (n = 144) or a placebo combined with 1,000 IU of vitamin D2 (n = 144) and followed for 2 years. Incidence of hip fractures in the two patient groups during the 2-year follow-up period was studied. At baseline, both groups of patients had low BMD with high levels of serum-ionized calcium and urinary deoxypyridinoline (D-Pyr). Hip fractures occurred in 14 patients in the placebo group and 4 in the alendronate group. The relative risk for hip fractures in the alendronate group as compared with the placebo group was 0.29 (95% CI, 0.10-0.85). The number of hip fracture per 1,000 patient-years was 14 and 49 for the alendronate and placebo groups, respectively. In the alendronate group, serum calcium and urinary D-Pyr levels decreased significantly during the follow-up period, while the levels in the placebo group were increased. BMD increased by 3.1% in the alendronate group and decreased by 2.8% in the placebo group (P < 0.01). Treatment with alendronate and vitamin D2 increases BMD in elderly women with PD and leads to the prevention of hip fractures.
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PMID:Alendronate and vitamin D2 for prevention of hip fracture in Parkinson's disease: a randomized controlled trial. 2737 61

Hip fractures are a major cause of disability, impairment and death in elderly people. It has been reported that bisphosphonates significantly reduce the risk of hip fracture among elderly women with confirmed osteoporosis but not among elderly women selected primarily on the basis of risk factors other than low bone mineral density. External hip protectors have been developed as a measure of reducing the impact of the fall and thereby the chance of hip fractures in such high risk people. The results of 14 randomized controlled trials for the prevention of hip fractures by using hip protectors have been reported until 2004. However, Cochrane review of hip protectors has concluded that their effectiveness is uncertain. Although further research is required with different conditions, the most important issue of hip protectors is the low adherence rate.
Clin Calcium 2006 Sep
PMID:[Progress in external hip protectors]. 1695 74

Hip fracture occurs relating to fall and decreased mechanical integrity of the femoral neck. Mechanical strength of the femoral neck is determined by both bone mineral density and other factors such as bone quality and hip geometry. Histomorphometrical studies show that cortical thinning, regional hyper-mineralization, decreased osteocyte lacunae and microdamage accumulation occur in aged or fractured subjects, suggesting that bone quality contributes mechanical integrity of femoral neck. Recent dual energy X-ray absorptiometry (DXA) studies revealed that hip axis length, longer in femoral neck fracture patients may contribute to the risk of femoral neck fracture.
Clin Calcium 2006 Dec
PMID:[Femoral neck structure in hip fracture]. 1714 23

Age- and gender-specific numbers of patients with hip fracture increase with age and peaked at the age 80-84; however, age- and gender-specific incidences increase exponentially with age. According to the recent nation-wide survey, the most common cause of hip fractures was a simple fall, 68.8% sustained fractures in-doors, and the incidences were higher in the winter than the summer period. More than 90% of patients with hip fracture were treated surgically and about 3/4 of patients with femoral neck fractures were treated with hemi-arthroplasty. Hip fractures for Asian people including Japanese are lower than those for Caucasians living in Northern Europe and North America; however, recent reports from the Asian area indicated an increase in the incidence with time.
Clin Calcium 2006 Dec
PMID:[Epidemiology of hip fracture]. 1714 24

Hip fracture is among the most common causes of acute immobilization in elderly patients, and elderly patients with hip fracture are at high risk for a subsequent hip fracture. At baseline, both groups had high serum concentrations of ionized calcium, high urinary deoxypyridinoline (DPD) concentrations, suggesting immobilization-induced hypercalcemia. We previously showed deficiency of vitamins D and K(1) causes reduced bone mineral density (BMD) in female Alzheimer's disease (AD) patients. In a random and prospective study of AD patients, 100 patients received 45 mg menatetrenone, 1,000 IU ergocalciferol and 600 mg calcium daily for 2 years, and the remaining 100 (untreated group) did not. Treatment with MK-4 and vitamin D(2) with calcium supplements increases the BMD in elderly female patients with AD and leads to the prevention of nonvertebral fractures. The risk of hip fracture after stroke is 2 to 4 times as high as that in age-matched healthy controls. Hyperhomocysteinemia is a risk factor for both ischemic stroke and osteoporotic fractures in elderly persons. Randomized, controlled, double-blinded study of 628 consecutive elderly hemiplegic patients at least 1 year following first ischemic stroke. Patients were assigned to daily oral treatment with 5 mg of folate and 1,500 microg of mecobalamin or double placebos, and 559 completed the 2 year follow up. Plasma homocysteine levels in the decreased by 38% in the treatment group and increased by 31% in the placebo group. The number of the hip fractures per 1,000 patient-years was 10 and 43 for the treatment and placebo groups, respectively (p<0.001). In this Japanese population with a high baseline fracture risk, combined treatment with folate and vitamin B(12) is safe and effective in reducing the risk of a hip fracture in elderly stroke patients. Because of limited study power, the relative risk reduction may only be around 0.5.
Clin Calcium 2006 Dec
PMID:[Immobilization and hip fracture]. 1714 29

Efforts aimed at preventing hip fractures include lifestyle advice for high-risk elderly, interventions to reduce the risk of falls and medication for osteoporosis. Alternative approach is the use of hip protectors. Hip protectors have pads designed to cover the greater trochanter and attenuate or disperse the force of a fall sufficiently to prevent a hip fracture. There are 14 randomized controlled trials (RCTs) included in the Cochrane systematic review until 2005. All RCTs were classified into three groups by the type of randomization; cluster randomized in institutions, individually randomized in institutions and individually randomized in community. There is little evidence to support the use of hip protectors outside the nursing home setting. Further research is required, primarily to produce a device that provide higher compliance, and which will then need to be tested in another RCT.
Clin Calcium 2006 Dec
PMID:[Do hip protectors decrease the risk of hip fracture in elderly?]. 1714 31

Hip fracture is associated with compromised patients'quality of life (QOL). Cost utility analysis (CUA) is one of the important applications of QOL evaluation. Cost per QALY (quality adjusted life years; life years multiplied by utility) is the major outcome in CUA. Utility can be measured with several ways. Standard gamble (SG) and time trade off (TTO) are considered to be the standard methods. They are, however, too cumbersome in clinical practice or study. Thus preference-based type of QOL questionnaires are often used for obtaining utility values. Since QOL is dependent on the cultural background of the society, the database for utility values associated with each disease states must be established in Japan. Future studies to build up such database are of utmost importance.
Clin Calcium 2006 Dec
PMID:[The impact of hip fracture on patients' quality of life (QOL) with emphasis on cost utility analysis]. 1714 32

Hip fractures are the most serious complication of osteoporosis and have been recognized as a major public health problem. In elderly persons, hip fractures occur as a result of increased fragility of the proximal femur due to osteoporosis. It is essential to precisely quantify the strength of the proximal femur in order to estimate the fracture risk and plan preventive interventions. Computed tomography (CT)-based finite element analysis could possibly achieve precise assessment of the strength of the proximal femur. We have developed a three dimensional simulation model that could accurately predict the strength and surface strains of the proximal femur using a CT-based finite element method. The axial CT scans of the proximal femora were obtained with a calibration phantom, from which the 3D finite element models were constructed. Materially nonlinear finite element analyses were performed. The yield and fracture loads were calculated, while the sites where elements failed and the distributions of the principal strains and stresses were determined. The simulation is patient specific and could provide us of a useful tool to evaluate fracture risk in patients with osteoporosis. The technology utilized in this method would make a rapid progress in accordance with the progress of both imaging and computer technologies and much more precise prediction of the fracture risk will be realized in the near future.
Clin Calcium 2006 Dec
PMID:[Prediction of bone strength using a CT based finite element method]. 1714 36

Chronic renal insufficiency (CRI) causes important modifications in the metabolism of phosphorus and calcium, to which frequently resulting in serious disorders of the skeleton, including demineralization, reduction of the bone resistance and a higher risk of fractures. Renal osteodystrophy is the term used to describe these disorders; they are generally heterogeneous and are classified according to the state of bone turnover into secondary hyperparathyroidism, adynamic bone, and osteomalacia. The incidence of hip fractures in the patients with CRI is higher than in the general population. Hip fractures are an important cause of morbidity and mortality. The evaluation of the fracture risk in the patients with different degrees of CRI is problematic, in particular because of the difficulty in identifying fractures, especially vertebral ones. The instrumental index that best expresses the fracture risk in the general population is bone mineral density (BMD); however, the relationship between low BMD and CRI is disputed. Bone disorders in patients with CRI have in fact a multifactorial pathogenesis and low BMD is not the only risk factor for fractures. Besides densitometric evaluation, also that vertebral morphometric evaluation would be desirable in patients with CRI. The fracture risk increases progressively with the severity of chronic renal disease and it is especially high in patients with renal insufficiency in more advanced-stages CRI (creatinine clearance<15-20 mL/min). However, not only in patients with severe CRI undergoing dialysis, but also in those with milder renal disease is the risk of bone fractures high.
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PMID:[Fractures and chronic renal insufficiency]. 1847 11


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