Medical Doctor, Professor of Mahidol University in Bangkok, Thailand, Aasis Unnanuntana, in his research, set a goal to find out whether there are differences in the short-term functional recovery of patients with a femoral neck fracture who received bisphosphonate treatment at week 2 versus week 12 after hemiarthroplasty. Bisphosphonate is used as the main therapy for the prevention and treatment of osteoporosis.
What method was used for the study? One hundred patients were randomly allocated into two groups intended for a randomized controlled trial. Both groups received risedronate 35 mg/week at the 2nd or 12th week after hemiarthroplasty. All patients received calcium and vitamin D supplementation. Functional recovery was assessed by de Morton Mobility Index, Barthel Index, EuroQol 5D, visual analog scale, 2-min walk test, and timed get-up-and-go test at 2 weeks, 3 months, and 1 year after surgery.
After 3 months, all functional performance indicators showed significant improvement in both groups. There were no statistically significant differences in the functional outcome between groups after both 3 months of follow-up and after the year. Although patients who received bisphosphonate at week 2 had a lower serum calcium level for 3 months and had more overall adverse events than patients in the 12-week group. All patients in both groups continued to take prescribed medications.
The conclusion of the study was that there were no significant differences in short-term functional recovery or significant adverse events between the two bisphosphonate groups. Thus, bisphosphonate therapy may be launched as early as 2 weeks after femoral neck fracture. It is important that the low level of calcium and vitamin D in the blood serum is corrected by the addition of calcium and vitamin D before or during the bisphosphonate initiation.