Shawn Yee, Mercer University College of Pharmacy
Hip fractures in the elderly population are associated with serious health consequences, which includes significant mortality, loss of mobility, and decreased independence. [1,2] Bisphosphonates are the most commonly used medications for osteoporosis treatment and prevention. [3,2] They work by inhibiting bone resorption and causing osteoclast apoptosis. [4,2] However, due to concerns with correcting low vitamin D and calcium levels as well as potentially negative effects on healing, the appropriateness of early treatment initiation of bisphosphonates is unclear. [5,2]
A recent meta-analysis (N= 10 trials, N= 2,888) that reviewed early versus late initiation of bisphosphonates after surgery for fractures found that fracture healing time was not delayed with early initiation of bisphosphonates. The included studies used alendronate, zoledronic acid, risedronate, and etidronate.  Below is a summary of a randomized controlled trial evaluating the effects of early versus late initiation of risedronate post-hemiarthroplasty.