Prior Fracture Systemically Raises Fracture Risk

In a study of 3,956 Caucasian women aged ≥ 65 years researchers found that having one fracture significantly increases a patient’s risk of fractures in other locations.

The study, “Incident fracture is associated with a period of accelerated loss of hip BMD (bone mineral density): the Study of Osteoporotic Fractures,” appears in the October 2018 edition of Osteoporosis International.

Co-author Blaine Christiansen, Ph.D., M.S., associate professor of orthopedic surgery at the University of California in Sacramento, explained the study to OTW, “In a previous study, we observed contralateral and systemic bone loss following anterior cruciate ligament (ACL) injury in mice. This was an unexpected and interesting observation for us, and it led us to hypothesize that post-traumatic systemic bone loss could be a contributing factor to increased fracture risk following an initial fracture, which has been thoroughly described in cohort studies.”

“We felt that this is an understudied and underappreciated injury response that could have tremendous consequences for patients following a traumatic injury.”

“For our study, we analyzed hip bone mineral density (BMD) in women from the Study of Osteoporotic Fractures (SOF). We found that women who had an incident fracture had greater reductions in total hip BMD [bone mineral density] over a 4-year period than women who did not fracture. We also found that this accelerated loss of hip BMD was isolated to the 2-year time interval that included the fracture.”

“A companion study recently published in the Journal of Bone and Mineral Researchexamined underlying mechanisms of systemic bone loss following fracture in mice. We found that mice lost significant bone volume within the first two weeks following a fracture, particularly from the trabecular bone compartment. Following fracture, mice also exhibited considerable systemic inflammation and altered cage activity, both of which could contribute to bone loss. Young mice were able to fully recover from this bone loss by six weeks post-fracture, but recovery in middle-aged mice was unclear.”

“I think it is important to realize that bone fractures and other musculoskeletal injuries, particularly severe injuries, can have serious systemic consequences for these patients, and could increase future fracture risk at all skeletal sites. I think it is likely that there are simple, easily implemented therapies that could be administered soon after an injury that will protect the skeletal health of these patients and improve their long-term quality of life.”