Older men sustain excess bone mineral density (BMD) declines after hip fracture; however, BMD provides no information on mechanical structure and strength. The aim was to assess whether changes in hip bone geometry in older men after hip fracture differ than that expected with aging. Two cohorts were used: Baltimore Hip Studies 7th cohort (BHS-7) and Baltimore Men's Osteoporosis Study (MOST). The sample (N = 170) included older Caucasian men with hip fracture that were propensity score matched (1:1) to community-dwelling non-fractured comparators. Hip Structural Analysis (HSA) calculated aerial BMD and metrics of bone structural strength: cross-sectional bone area (CSA), cortical outer diameter (OD), section modulus (SM), and centroid position (CP). Mixed-effect models estimated changes in HSA parameters and adjusted robust regression models evaluated between-cohort differences in annual percent change at the narrow neck (NN), intertrochanteric (IT), and femoral shaft (FS). Hip fracture was associated with statistically greater declines in NN CSA (β = -2.818; 95% CI: -3.300%, -2.336%), SM (β = -1.896%; 95% CI: -2.711%, -1.080%) and CP (-0.884%; 95% CI: -0.889%, -0.088%) and significantly larger increases in NN OD (β = 0.187%; 95% CI: 0.185%, 0.190%). Differences in IT HSA parameters were like the NN but larger in magnitude, while there were favorable changes in FS geometry where fragility fractures are rare. Findings indicate there are declines in bone structure and strength at the NN and IT regions of the proximal femur in older men during hip fracture recovery that far exceed what occurs during normal aging.

中文翻译：

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髋部骨折男性与未骨折比较者之间对侧髋关节几何强度的差异

老年男性髋部骨折后骨密度 (BMD) 下降过多；但是，BMD 没有提供有关机械结构和强度的信息。目的是评估老年男性髋部骨折后髋骨几何形状的变化是否与预期的衰老有所不同。使用了两个队列：巴尔的摩髋关节研究第 7 队列 (BHS-7) 和巴尔的摩男性骨质疏松症研究 (MOST)。样本 (N = 170) 包括与社区居住的非骨折比较者的倾向评分匹配 (1:1) 的老年髋部骨折高加索男性。髋部结构分析 (HSA) 计算空中 BMD 和骨结构强度指标：骨横截面面积 (CSA)、皮质外径 (OD)、截面模量 (SM) 和质心位置 (CP)。混合效应模型估计了 HSA 参数的变化，调整后的稳健回归模型评估了窄颈 (NN)、转子间 (IT) 和股骨干 (FS) 的年度百分比变化的队列间差异。髋部骨折与 NN CSA (β = -2.818; 95% CI: -3.300%, -2.336%), SM (β = -1.896%; 95% CI: -2.711%, -1.080%)和 CP（-0.884%；95% CI：-0.889%，-0.088%）和显着更大的 NN OD 增加（β = 0.187%；95% CI：0.185%，0.190%）。IT HSA 参数的差异与 NN 类似，但幅度更大，而 FS 几何形状发生有利变化，其中脆性断裂很少见。