{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:30:28Z","timestamp":1789468228944,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T00:00:00Z","timestamp":1654128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is conjecture on the optimal timing to administer bisphosphonate therapy following operative fixation of low\u2010trauma 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\u2010analysis to determine if early administration of bisphosphonate therapy within the first month post\u2010operatively following proximal femur fracture fixation is associated with delay in fracture healing or rates of delayed or non\u2010union.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u2009month of operation with a control group. Data were pooled in meta\u2010analyses where possible. The Cochrane Risk of Bias Tool and the GRADE approach were used to assess validity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For the outcome of time to fracture union, meta\u2010analysis of three studies (<jats:italic>n<\/jats:italic>\u00a0=\u00a0233) found evidence for earlier average time to union for patients receiving early bisphosphonate intervention (MD\u00a0=\u00a0\u22121.06\u2009weeks, 95% CI \u22122.01\u2013\u22120.12, I<jats:sup>2<\/jats:sup>\u00a0=\u20098%). 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\u20131.46). Meta\u2010analyses did not demonstrate a difference in outcomes of mortality, function or pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We provide low\u2010level evidence that there is no reduction in time to healing or delay in bony union for patients receiving bisphosphonates within 1\u2009month of proximal femur fixation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17792","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T04:45:07Z","timestamp":1654231507000},"page":"2840-2848","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Early bisphosphonate therapy post proximal femoral fracture fixation does not impact fracture healing: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8730-6843","authenticated-orcid":false,"given":"Yui Yee Felice","family":"Tong","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Holmes","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Sefton","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Dubbo Base Hospital  Dubbo New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,2]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Osteoporosis","author":"Australian Institute of Health & Welfare","year":"2020"},{"key":"e_1_2_9_3_1","volume-title":"Model of Care for Osteoporotic Refracture Prevention Model of Care","author":"NSW Agency for Clinical Innovation","year":"2017"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa074941"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0317"},{"key":"e_1_2_9_6_1","volume-title":"ANZHFR Annual Report of Hip Fracture Care 2021","author":"Australian and New Zealand Hip Fracture Registry","year":"2021"},{"key":"e_1_2_9_7_1","volume-title":"Hip Fracture Care Clinical Care Standard","author":"Australian Commission on Safety and Quality in Health Care","year":"2016"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-017-0324-5"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/M15-1361"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.1999.14.6.969"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10195-010-0083-1"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1359\/JBMR.050712"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-006-0212-y"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.070318"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20120525-51"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2011.07.957"},{"key":"e_1_2_9_17_1","first-page":"bcr2013201931","article-title":"Delayed union after atypical subtrochanteric fracture under alendronate treatment: case report","volume":"22","author":"Czerwinkski E","year":"2011","journal-title":"Osteoporos. 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