Search Results (250)

Objective: This study aimed to investigate the association between time to admission (TTA) and long-term mortality in patients with hip fractures, enabling surgeons to assess individual risks and prevent adverse outcomes. Methods: Demographic and clinical data of patients with hip fractures were obtained from medical records in our hospital. Patients aged 65 years or older were included. TTA was defined as the time from injury to first presentation at our institution. The primary outcome was long-term all-cause mortality. The regular multivariate Cox regression, restricted cubic spline, and two-piecewise model were used to explain the linear and curvilinear association between TTA and long-term mortality. The analyses were performed using EmpowerStats and R. Results: A total of 2361 patients were included in our study. There were 743 males and 1618 females, with a mean age of 79.44 ± 6.71 years. There were 1745 intertrochanteric fractures and 616 femoral neck fractures. We divided the patients into four groups according to TTA distribution: TTA ≤ 6 h, 6 h < TTA ≤ 12 h, 12 h < TTA ≤ 24 h, and TTA > 24 h, and the corresponding long-term mortality rates were 254 (25.53%), 85 (32.20%), 127 (32.56%), and 267 (37.50%). A curvilinear association was observed between TTA delay and long-term mortality in geriatric hip fractures, with 24 h serving as an inflection point. When TTA was less than 24 h, every one-hour increase in TTA was associated with a 1.6% increase in long-term mortality (HR = 1.016, 95% CI: 1.008–1.024; p < 0.001). When TTA exceeded 24 h, the long-term mortality risk showed no significant further increase with TTA (HR = 1.000, 95% CI: 1.000–1.000; p = 0.531). Conclusions: This study suggests that delayed admission is associated with a worse prognosis, and the mortality risk increases by approximately 1.6% per hour of delay within the first 24 h, after which the risk appears to stabilize. The first 24 h post-injury may represent a critical window for intervention. Full article

Background/Objectives: Abaloparatide is an osteoanabolic therapy used in patients at high risk of fracture; however, the breadth of evidence across routes, comparators, and sequential strategies has not yet been comprehensively summarized. This study aimed to evaluate the efficacy and safety of abaloparatide for reducing fractures and improving bone mineral density (BMD) in adults with osteoporosis. Methods: Following PRISMA 2020, we searched PubMed, Embase, CENTRAL, and Web of Science (2016–2024) for randomized controlled trials and comparative real-world studies. Additional meta-analyses and network meta-analyses were included as contextual evidence but not pooled to avoid double-counting. Primary outcomes were vertebral, non-vertebral, and hip fractures; secondary outcomes included percentage change in BMD and safety endpoints. Random-effects models were used; heterogeneity, influence analyses, and prediction intervals were examined. Risk of bias was assessed using RoB 2 and AMSTAR 2. Results: Nine quantitative evidence sources met the criteria. Abaloparatide reduced vertebral fractures (RR 0.13–0.21) and showed moderate reductions in non-vertebral fractures. Lumbar spine BMD increased substantially, while hip and femoral neck gains were smaller and heterogeneous. Hypercalcemia risk was consistently lower compared to teriparatide. Transdermal delivery was less effective, and sequential abaloparatide → antiresorptive therapy further reduced fractures. Serious adverse events were not increased. Conclusions: Abaloparatide provides strong vertebral protection, significant BMD improvement, and shows a favorable calcemic profile, with moderate certainty for non-vertebral effects. Evidence in men and long-term safety remains limited. Full article

Background/Objectives: Patients with myasthenia gravis (MG) are at increased risk of osteoporotic fractures due to long-term oral corticosteroid use and disease-related muscle weakness. FRAX^® estimates 10-year fracture probability but does not incorporate falls or MG-specific functional impairment. To explore heterogeneity of fracture occurrence within MG patients classified as high risk by FRAX major osteoporotic fracture (MOF) probability. Methods: In a single-center retrospective cohort of 68 MG patients assessed in 2012, FRAX MOF with femoral neck BMD was calculable in 54 patients; the 29 patients with FRAX MOF ≥ 9.0% (the median of these 54 patients) comprised the high-FRAX cohort. Patients were stratified by the cohort medians of age (67 years) and MG-ADL (2 points) into four strata (HH, HL, LH, LL). This median-based stratification was exploratory and not intended as a clinically meaningful threshold. The primary outcome was time to first MOF (up to 10 years). We compared fracture occurrence using both proportions and Kaplan–Meier analyses (log-rank test) and performed exploratory univariable Cox models for selected predictors. No multivariable confounder adjustment was performed. Results: Eight of twenty-nine patients (27.6%) experienced an MOF. The proportions with MOF were HH 25.0%, HL 40.0%, LH 57.1%, and LL 0.0% (global p = 0.068). Kaplan–Meier curves differed across strata (log-rank p = 0.03), with separation most evident between LH and LL. For univariable Cox analyses, age was associated with shorter time to MOF (hazard ratio [HR] 1.13 per year, p = 0.041), and baseline difficulty rising from a chair (MG-ADL item) was associated with higher hazard rates (HR 3.45, p = 0.048). Conclusions: In this small, selected high-FRAX MG cohort, fracture events appeared to cluster in patients with impaired ADL and fall-related MG-ADL abnormalities, whereas FRAX values remained strongly age-driven. These findings are exploratory and hypothesis-generating and should not be interpreted as evidence of FRAX miscalibration; confirmation in larger, prospectively followed cohorts is needed. Full article

Background: Osteoporosis and osteopenia are prevalent bone diseases characterized by reduced bone mineral density (BMD) and an increased risk of fractures, particularly in postmenopausal women. While dual-energy X-ray absorptiometry (DXA) remains the gold standard for diagnosis, it has limitations regarding accessibility, cost, and predictive capacity for fracture risk. Machine learning (ML) approaches offer an opportunity to develop automated and more accurate diagnostic models by incorporating both BMD values and clinical variables. Method: This study retrospectively analyzed BMD data from 142 postmenopausal women, classified into 3 diagnostic groups: normal, osteopenia, and osteoporosis. Various supervised ML algorithms—including Support Vector Machines (SVM), k-Nearest Neighbors (k-NN), Decision Trees (DT), Naive Bayes (NB), Linear Discriminant Analysis (LDA), and Artificial Neural Networks (ANN)—were applied. Feature selection techniques such as ANOVA, CHI2, MRMR, and Kruskal–Wallis were used to enhance model performance, reduce dimensionality, and improve interpretability. Model performance was evaluated using 10-fold cross-validation based on accuracy, true positive rate (TPR), false negative rate (FNR), and AUC values. Results: Among all models and feature selection combinations, SVM with ANOVA-selected features achieved the highest classification accuracy (94.30%) and 100% TPR for the normal class. Feature sets based on traditional diagnostic regions (L1–L4, femoral neck, total femur) also showed high accuracy (up to 90.70%) but were generally outperformed by statistically selected features. CHI2 and MRMR methods also yielded robust results, particularly when paired with SVM and k-NN classifiers. The results highlight the effectiveness of combining statistical feature selection with ML to enhance diagnostic precision for osteoporosis and osteopenia. Conclusions: Machine learning algorithms, when integrated with data-driven feature selection strategies, provide a promising framework for automated classification of osteoporosis and osteopenia based on BMD data. ANOVA emerged as the most effective feature selection method, yielding superior accuracy across all classifiers. These findings support the integration of ML-based decision support tools into clinical workflows to facilitate early diagnosis and personalized treatment planning. Future studies should explore more diverse and larger datasets, incorporating genetic, lifestyle, and hormonal factors for further model enhancement. Full article

Background and Objectives: Short femoral stems are increasingly used in total hip arthroplasty (THA), yet evidence regarding their performance in elderly femoral neck fracture (FNF) patients is limited. In this study, we compared clinical and radiographic outcomes of the use of a short femoral stem (SFS) versus a conventional standard stem (CSS) in cementless THA. Materials and Methods: This prospective, single-center case–control study (1:2) included patients ≥ 65 years of age with displaced FNF (Garden 3–4) treated with cementless THA. Follow-up lasted a minimum of 2 years. Clinical evaluations included the Harris Hip Score (HHS), Roles and Maudsley satisfaction score, and thigh pain assessment. Radiographic evaluations assessed cup position, osseointegration (Moore signs), radiolucencies (DeLee–Charnley and Gruen zones), subsidence, leg length discrepancy (LLD), and heterotopic ossification. Results: A total of 114 patients were analyzed (38 with SFS versus 76 with CSS). The final follow-up HHS was 87 ± 2.7 (SFS) and 88 ± 2.5 (CSS) (p = 0.231), and satisfaction was excellent in nearly all patients in both groups. Thigh pain was rare and resolved by final follow-up in all SFS patients, and no radiographic loosening was observed. Early subsidence (≤3 mm) occurred in two SFSs and three CSSs without progression, while LLD < 1 cm was present in three SFS and eight CSS cases. No implant-related revisions occurred, and complication rates were low and comparable. Conclusions: Short femoral stems provided clinical and radiographic outcomes equivalent to those of conventional stems in elderly FNF patients treated with cementless THA. Short stems appear to be a safe and effective option in this population, and further studies with longer follow-up are needed to confirm their durability. Full article

Background and Objectives: Handgrip strength (HGS) is a simple marker of muscular fitness that has been linked to adverse outcomes in older adults, while menopause is accompanied by skeletal deterioration and increased psychological vulnerability. Resilience and self-regulation may be associated with lower levels of these risks, but their relationship with bone microarchitecture has not been clarified. We aimed to examine the associations between HGS and trabecular bone score (TBS), bone mineral density (BMD), mental health, resilience, and self-regulation in postmenopausal women. Materials and Methods: In this study, 200 postmenopausal women were recruited. HGS was assessed with a dynamometer, BMD at the lumbar spine, total hip and femoral neck by DXA, and lumbar TBS was derived from spine images. Psychological distress was measured with the DASS-21, resilience with the Brief Resilience Scale (BRS), and self-regulation with the Short Self-Regulation Questionnaire (SSRQ). Results: TBS was significantly higher in women with higher HGS (p < 0.001). Higher HGS was also associated with lower anxiety and depression scores (p = 0.011 and p = 0.013), fewer self-reported mental health disorders, and greater resilience (p < 0.001) and self-regulation (p = 0.004). Resilience and self-regulation were inversely related to all DASS-21 subscales (all p < 0.001), and HGS correlated positively with BRS (p < 0.001) and SSRQ (p < 0.001). TBS correlated modestly with both BRS (p = 0.003) and HGS (p < 0.001). In multiple linear regression, both BRS (β = 0.018, p = 0.013) and HGS (β = 0.003, p = 0.006) remained independently associated with TBS after adjustment for age, BMI, menopause duration, and SSRQ. Conclusions: In postmenopausal women, higher handgrip strength is associated to better trabecular bone microarchitecture and a more favorable psychological profile. Incorporating HGS and brief psychosocial assessment alongside TBS may enrich fracture risk stratification and support more integrated musculoskeletal and mental health care. Full article

Background/Objectives: Cement augmentation of cephalomedullary head elements can improve the purchase of osteoporotic bone; however, it does not eliminate the need for accurate implant positioning or the preservation of sliding. We report the case of an 87-year-old woman who underwent intramedullary nailing with a cement-augmented helical blade for intertrochanteric fracture. Methods: This is a single-patient case report. Calibrated radiographic measurements—tip–apex distance (TAD), calcar-referenced TAD (CalTAD), neck–shaft angle (NSA), and telescoping—were obtained immediately postoperatively and at 4, 7, 12, and 15 months. CT was performed at postoperative week 1 and at failure, and MRI was performed for clinical deterioration. In addition, a targeted narrative review summarizes the evidence on the head-element position, sliding behavior, reduction alignment, and augmentation. Results: Immediate postoperative indices were within the accepted targets: TAD 22.6 mm, CalTAD 22.8 mm, NSA 134°, with the head element inferior on the anteroposterior view and central on the lateral view. Rehabilitation proceeded with full weight bearing as tolerated. Early telescoping was minimal (3.8–3.9 mm). Between 7 and 15 months, progressive varus with shortening of TAD/CalTAD and little additional telescoping was observed, radiographically consistent with relative proximal migration of the head–cement complex and a cleavage plane along the inferior cement mantle, culminating in a subcapital femoral neck fracture with the implant in situ. Emphasis should be placed on accurate implant positioning and preservation of sliding capacity, because cement augmentation alone may not prevent mechanical failure when the implant position or load transfer is suboptimal. Conclusions: Cement augmentation stiffens the interface and reduces micromotion but does not neutralize malposition-induced stresses. Accurate positioning, preservation of sliding, and timely conversion when sliding fails to progress are advisable; these findings are hypothesis-generating from a single case. We propose a position- and sliding-based decision guide to support clinical decision-making; its usefulness remains to be validated in larger studies. Full article

Background: Femoral neck fractures in the elderly often necessitate hemiarthroplasty, but the optimal surgical approach remains a highly debated topic. The postero-lateral and direct lateral approaches are commonly employed, each with benefits and drawbacks. Despite their widespread use, robust, long-term comparative studies on definitive outcomes, including pain, functional recovery, and complication rates, are notably lacking. This systematic review and meta-analysis aim to address this critical gap by meticulously comparing these approaches with long-term follow-up. Methods: A systematic literature search was performed, including only comparative studies with a minimum 1-year follow-up. A meta-analysis was performed for the primary outcome measures: operative time, dislocations, infections, perioperative fractures and reoperations. Secondary outcomes included a qualitative synthesis of patient-reported outcomes (quality of life, pain, and satisfaction). Methodological quality was assessed using RoB 2.0 for randomized controlled trials and MINORS criteria for cohort studies. Results: Our meta-analysis provides robust quantitative evidence. The direct lateral approach is associated with a significantly lower risk of post-operative dislocations (I² = 58%; OR = 2.86, 95% CI: 2.53 to 3.22; p < 0.00001) and a significantly lower rate of reoperation (I² = 0%; OR = 1.25, 95% CI: 1.12 to 1.40; p = 0.0001) compared to postero-lateral approach. Operative time, infection, and perioperative fracture rates were found to be statistically comparable. However, patient-reported outcomes yielded inconsistent results across studies, often becoming non-significant after adjusting for confounders. Conclusions: This meta-analysis shows that the direct lateral approach is associated with lower rates of dislocation and reoperation compared with the postero-lateral approach, while patient-reported outcomes remain variable across studies. Further high-quality comparative trials are needed to confirm these associations and guide surgical decision-making. Full article

Background: Postmenopausal osteoporosis (PMO) is a major cause of fragility fractures worldwide. While exercise and calcium/vitamin D are standard preventive measures, the synergistic effects of their combined use on bone mineral density (BMD) remain unclear. Methods: We systematically searched eight databases through October 2025 and synthesized data using Review Manager version 5.4. Subgroup, sensitivity, and meta-regression analyses were conducted to examine heterogeneity and test the robustness of results. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and the certainty of evidence was graded with the GRADE framework. Results: 13 RCTs involving postmenopausal women were included. Compared with calcium and vitamin D supplementation alone, combined interventions significantly increased lumbar spine (SMD = 0.31, 95% CI [0.06, 0.55]) and femoral neck BMD (SMD = 0.47, 95% CI [0.09, 0.84]), with consistent but nonsignificant trends at other skeletal sites. Subgroup analyses showed that whole-body vibration produced the greatest and most consistent benefits at both sites, while mind–body or traditional Chinese exercises (e.g., Baduanjin) significantly improved lumbar spine BMD. Shorter interventions (≤6 months) yielded greater gains in BMD, whereas longer durations provided no additional advantage. Conclusions: Exercise combined with calcium and vitamin D supplementation effectively improves bone mineral density in postmenopausal women, especially at the lumbar spine and femoral neck. Whole-body vibration and mind–body exercises show the greatest benefits, with short-term interventions proving most effective. This combined approach offers a practical, evidence-based strategy to preserve skeletal health in aging women. Full article

Background/Objectives: Dietary patterns play a crucial role in musculoskeletal health; however, the effects of different diets on bone mineral density (BMD), fracture risk, and bone metabolism remain inconsistent across studies. This systematic review and meta-analysis aimed to evaluate the impact of Mediterranean, calorie restriction, high-protein, low-carbohydrate, and ketogenic diets on skeletal outcomes in adults. Methods: A comprehensive search of PubMed/MEDLINE, CENTRAL, and Web of Science was conducted for studies published between January 2000 and June 2025. Eligible randomised controlled trials (RCTs) and cohort studies involving adults (≥18 years) and reporting outcomes related to BMD, fractures, bone turnover markers, and vitamin D or calcium status were included. Risk of bias was assessed using the Cochrane’s Risk of Bias tool for RCTs and the Joanna Briggs Institute checklist for observational studies. Random-effects meta-analyses were performed for outcomes reported by ≥3 comparable studies, presenting standardised mean differences (SMDs) for BMD and hazard ratios (HRs) for fractures. Results: Thirty studies met inclusion criteria, comprising 14 RCTs and 16 observational studies with over 500,000 participants. Pooled analyses showed no significant differences in BMD at the femoral neck (SMD = 0.12, 95% CI −0.80 to 1.04), lumbar spine (SMD = 0.04, 95% CI: −1.12 to 1.03), total hip (SMD = −0.07, 95% CI −0.36 to 0.21), or whole body (SMD = 0.03, 95% CI −0.07 to 0.14) across diet categories. However, adherence to a Mediterranean diet was associated with a significantly reduced hazard of hip and overall fractures (pooled HR = 0.95, 95% CI 0.93–0.96). Calorie restriction consistently increased bone resorption markers, whereas Mediterranean and high-protein diets showed neutral or modestly favourable effects. Vitamin D and calcium status were minimally affected across interventions. Conclusions: While dietary patterns exert diverse effects on skeletal health, consistent evidence supports Mediterranean-style diets as protective against fractures. Calorie restriction may elevate bone turnover, whereas ketogenic and high-protein diets show mixed effects on bone. However, across all analyses, high heterogeneity was observed. Further high-quality RCTs are warranted to clarify these relationships and inform dietary guidance for bone health. Full article

Background/Objectives: Chronic synovitis is a hallmark of osteoarthritis (OA) progression, driving cartilage degradation via inflammatory mediators. While the MAPK signaling pathway is implicated in OA pathogenesis its activation patterns in hip synovium remain poorly characterized, and regional differences within the synovial membrane have not been systematically examined. This research aims to determine the expression of extracellular signal-regulated kinase 1/2 (ERK1/2), p38 mitogen-activated protein kinase (p38 MAPK), c-Jun N-terminal kinase (JNK), and the Epidermal Growth Factor Receptor (EGFR) in the MAPK signaling pathway in the synovial membrane of osteoarthritic hips. Methods: We compared synovial immunofluorescence expression of the aforementioned proteins in a control (CTRL) group of subjects with femoral neck fractures and a group with hip OA. Results: Higher ERK1/2 immunoexpression was detected in the intima compared with the subintima in the CTRL group (p < 0.05), and a similar distribution was observed in the OA group (p < 0.0001). The intima of the OA group exhibited a considerably greater area percentage of positive signal than the intima of the CTRL group (p < 0.01). In all groups examined, we observed that p38 MAPK expression was markedly more positive in the intima than in the subintima (p < 0.0001), but without statistically significant differences between groups. JNK and EGFR immunoexpression were higher in the intima than in the subintima across all analyzed groups, but the difference did not reach statistical significance (p > 0.05). No differences in the expression of these two markers were detected between the CTRL and OA groups (p > 0.05). Differential analysis of the GEO dataset revealed no significant differences in expression between the OA and CTRL groups in the expression of MAPK1, MAPK3, MAPK8, MAPK9, MAPK10, and MAPK11. EGFR was significantly elevated in OA compared to CTRLs in the differential analysis of the GEO dataset. Conclusions: This study provides the first comprehensive analysis of MAPK pathway activation in hip OA synovium, revealing ERK1/2 as a key player with region-specific upregulation in the synovial intima. Combined with elevated EGFR expression, these findings suggest potential therapeutic targets for hip OA synovitis. The discordance between protein and mRNA levels for ERK1/2 indicates post-transcriptional regulation, warranting further investigation into phosphorylation status and functional activation. Our results support the development of targeted interventions for hip OA, a condition with limited treatment options beyond joint replacement. Full article

Background: Hip fractures in older adults are sentinel events linked to high mortality and functional decline. Few studies have quantified long-term survival probabilities, standardized mortality ratios (SMRs), and risks of new nursing home admission alongside patient-related predictors. Methods: We retrospectively analyzed 355 patients aged ≥ 60 years who underwent hip fracture surgery at a general hospital in Japan (2020–2024). Primary outcomes were mortality and new nursing home admission. Survival probabilities and remaining life expectancy were estimated, and SMRs were calculated using age- and sex-matched national data. Cox regression identified independent predictors. Results: Mean age was 84 years; 76% were female. Mortality probabilities at 1, 2, and 3 years were 23%, 41%, and 60%, respectively; SMRs consistently exceeded 9. Median remaining life expectancy was 260 days. New nursing home admissions occurred in 42%, with cumulative probabilities of 16%, 27%, and 35% at 1, 2, and 3 years, respectively, showing a rapid rise within 9 months. Independent predictors of mortality were delayed surgery, higher Charlson Comorbidity Index, and low Geriatric Nutritional Risk Index. Older age and failure to regain ambulatory ability at 3 months predicted institutionalization. Conclusions: Older adults with hip fractures face persistently high mortality and institutionalization risks, comparable to advanced malignancies or neurodegenerative diseases. Surgical timing, comorbidities, nutrition, and functional recovery critically influence prognosis and should guide perioperative care and discharge planning. Full article

Background: Bone mineral density (BMD) assessed by DXA is a well-established predictor of osteoporotic fracture risk. However, data regarding the Polish female population remains limited. Objective: To evaluate the predictive value of BMD measurements for vertebral, hip, and all low-energy fractures in women aged 50 years and older. Methods: A total of 1.311 women from the Małopolska region underwent BMD assessment at the femoral neck, lumbar spine. The average follow-up period was 10.2 years, during which 479 osteoporotic fractures were recorded. Results: DXA measurements at the femoral neck showed the strongest correlation with hip fracture risk. Each one standard deviation decrease in the femoral neck T-score increased the risk of hip fracture by 2.1 times (HR 2.10; 95% CI 1.28–3.46; p = 0.003), after adjusting for age, but is not linear. A 1 SD decrease in the hip T-score was associated with a 28% increase in the risk of all osteoporotic fractures (HR 1.28; CI 1.17–1.40; p < 0.001), 53% increase in vertebral (HR 1.53; CI 1.13–2.08; p = 0.006) and 30% in hip (HR 1.30; CI 0.81–2.09; p = 0.278). The AUC values for hip BMD and hip T-score had the highest predictive value—AUC (area under the curve was 0.732 and 0.720, p < 0.01). Conclusions: BMD at the femoral neck proved to be a stronger predictor of hip fractures than measurements at the spine, radius. The risk increase associated with BMD/T-score reduction was non-linear. These findings confirm results from other benchmark studies. Full article

Background and objectives: Hemiarthroplasty (HA) remains one of the most common treatments for displaced femoral neck fractures in the elderly, providing pain relief, early mobilization and a low reoperation risk. Acetabular erosion is a recognized late complication of this procedure, but early cartilage wear and its potential relationship with infection remain poorly understood. The aim of this study was to describe the clinical and microbiological characteristics of patients who required conversion to total hip arthroplasty (THA) because of acetabular erosion and to analyze the possible role of unexpected infection as a contributing factor. Materials and methods: A retrospective observational study was performed including all patients treated between 2007 and 2019 who underwent conversion of a failed HA to THA due to acetabular erosion after femoral neck fracture. Microbiological analysis was performed in all cases through multiple intraoperative samples. Patients were classified into two groups, with and without infection, according to positive microbiological cultures. Results: Forty-four patients were included, with a median age of 80.5 years (74–85). The median time to acetabular erosion was 25.4 months (10.4–47.4). Infection was identified in six patients (13.6%), all within the first six months after fracture (p = 0.029). The median time to erosion was shorter in infected patients (4.0 versus 29.8 months, p < 0.001). No other demographic, functional, or implant-related variables were associated with infection. There were three re-revisions, two due to recurrent dislocation and one periprosthetic infection in a hip without unexcepted positive culture. All patients with positive intraoperative culture were successfully managed with antibiotherapy. Postoperative functional scores improved significantly in both groups. Fifteen patients (34.1%) died during follow-up. Conclusions: Early acetabular erosion after hemiarthroplasty may represent a manifestation of previously unrecognized low-grade infection, particularly in frail elderly patients. Despite advanced age and multiple comorbidities, conversion to THA achieved significant functional improvement with an acceptable complication rate. Prospective studies with larger populations are warranted to confirm the relationship between infection and early acetabular cartilage loss. Full article

Background/Objectives: Hip fracture patients commonly exhibit impaired nutritional status, including low serum albumin levels related to sarcopenia, which may affect recovery. This study evaluated the effect of branched-chain amino acid (BCAA) supplementation on serum albumin levels in hip fracture patients. Methods: This retrospective analysis was conducted at a single tertiary referral center on a cohort of patients with hip fractures including femoral neck and intertrochanteric fractures who visited the emergency department between January 2022 and November 2023. After propensity score matching, 106 patients were analyzed (BCAA: n = 53; control: n = 53); prior to matching, 67 treated and 110 control patients were eligible. Patients receiving BCAA supplementation were administered three times daily for six weeks postoperatively and they were matched with controls based on clinical and demographic variables. Controls received standard perioperative care without BCAA supplementation, and no placebo was administered. Serum albumin levels were measured before the surgery and 6 weeks postoperatively. After propensity score matching, 53 patients from each cohort were analyzed. The primary outcome was the difference in serum albumin levels; secondary outcomes were the length of hospital stay (LOS), blood transfusions (Tf), and the incidence of delirium. Results: The matched cohorts exhibited comparable baseline characteristics. Analysis revealed a significant increase in serum albumin levels among patients who received BCAA supplementation compared to the matched control group. No differences were found in terms of LOS, Tf, and the incidence of delirium during the index admission. Conclusions: This preliminary study suggests a potential positive effect of BCAA supplementation on serum albumin levels in patients with hip fractures. Further prospective investigations with larger sample sizes are warranted to validate these findings and elucidate the clinical implications for nutritional support in this population. Full article