Ma Yimin, Ge Yufeng, Guo Zhe, Su Yongbin, Wang Chao, Wang Qianqian, Wang Ling, Cheng Xiaoguang, Yang Minghui, Yan Dong
Department of Radiology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
BMC Musculoskelet Disord. 2025 Mar 10;26(1):233. doi: 10.1186/s12891-025-08368-7.
Postmenopausal female patients with a history of a single hip fracture are at higher risk of a second fracture. The poorer clinical outcomes of this patient group warrants evaluating the risk of experiencing a second hip fracture. Therefore, this study aimed to investigate the effectiveness of hip structural analysis (HSA) in assessing the risk of second hip fracture in postmenopausal females.
This retrospective analysis included 188 patients selected from the Chinese Second Hip Fracture Evaluation (ClinicalTrials.gov identifier: NCT03461237, first registration/posted date: 09/03/2018). They were divided into the second hip fracture (35 cases, with a mean age of 79.33 ± 7.70 years) and the control group (153 cases, with a mean age of 73.41 ± 9.56 years). Parker Mobility Score were determined via telephone follow-up, and two computed tomography scanners were used for images acquisition. All HSA and areal bone mineral density (aBMD) parameters were calculated through Mindways QCTPRO software.
The refracture group showed increased age, decreased cross-sectional area, total hip aBMD, trochanteric aBMD, and intertrochanteric aBMD (p < 0.05). Total hip and intertrochanteric aBMD have a protective effect on the occurrence of a second hip fracture in postmenopausal women, with odd ratios of 0.61 and 0.57, respectively (p < 0.05). Incorporating HSA parameters into the baseline model (used age, type 2 diabetes mellitus, and the PMS as parameters, AUC = 0.729) does not significantly improve the performance of second hip fracture prediction (AUC = 0.748, p < 0.05 in Delong's test).
Based on our findings, HSA does not statistically correlate with the incidence of second hip fracture in postmenopausal women. Incorporating HSA parameters into the (baseline) model does not significantly improve the pridictive capabilities.
有单次髋部骨折病史的绝经后女性患者发生二次骨折的风险较高。该患者群体较差的临床结局值得对发生二次髋部骨折的风险进行评估。因此，本研究旨在探讨髋部结构分析（HSA）在评估绝经后女性二次髋部骨折风险中的有效性。
本回顾性分析纳入了从中国第二次髋部骨折评估中选取的188例患者（ClinicalTrials.gov标识符：NCT03461237，首次注册/发布日期：2018年3月9日）。他们被分为二次髋部骨折组（35例，平均年龄79.33±7.70岁）和对照组（153例，平均年龄73.41±9.56岁）。通过电话随访确定帕克活动评分，并使用两台计算机断层扫描仪进行图像采集。所有HSA和面积骨密度（aBMD）参数均通过Mindways QCTPRO软件计算。
再骨折组患者年龄增加，横截面积、全髋aBMD、转子间aBMD和转子间aBMD降低（p<0.05）。全髋和转子间aBMD对绝经后女性二次髋部骨折的发生有保护作用，优势比分别为0.61和0.57（p<0.05）。将HSA参数纳入基线模型（以年龄、2型糖尿病和PMS作为参数，AUC = 0.729）并没有显著提高二次髋部骨折预测的性能（AUC = 0.748，德龙检验p<0.05）。
根据我们的研究结果，HSA与绝经后女性二次髋部骨折的发生率在统计学上无相关性。将HSA参数纳入（基线）模型并没有显著提高预测能力。
