Testosterone gel gives women hope after hip fractures

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Every 11 seconds, an older adult is treated in the emergency room for a fall, and every 19 minutes, an older adult dies from one.

Doctors are trying to improve those statistics. They're testing weightlifting and testosterone supplements to give women who break a hip a better shot at a full recovery.

Joan Mowery hits the gym twice a week. It's all part of her recovery from a broken hip.

"I might be 79 physically, but mentally, I'm not, and you know, no, this ain't going to stop me," she said.

Each year, 300,000 Americans break a hip. Seventy-five percent never get back to the function they had before the fracture.

"When I saw the statistics, I was horrified. I really was. 75%? That's outrageous," Mowery said.

But that's not the only grim statistic.

"A significant number of patients do not survive after the hip fracture. There's about a 25% mortality rate within the first year," Washington University Dr. Ellen Binder said.

Binder is testing a testosterone supplement with an extended weightlifting program to improve those odds for women.

"They are getting better. And they are getting stronger," she said.

Testosterone increases muscle and bone mass. Women use the gel once a day and lift weights twice a week for six months. A pilot study shows this approach improves mobility, lean body mass and strength.

"The functional aspect of this is really the muscles getting stronger, the walking getting better, the balance getting better," Binder said.

Mowery has already seen the benefit.

"Not only am I improving on the side that was fractured, I'm improving all the way around," she said.

She plans to join her own gym when the study is over. There's no chance she'll let herself become a statistic.

"I've got too much to do. I'm not done," Mowery said.

On average, most people will get about three weeks of inpatient rehab after a hip fracture, depending on their insurance, followed by a few weeks at home. The rehab program in this study is six full months. Doctors hope that extended rehab will get women back to their old selves and reduce the risk of future fractures.

The study is still recruiting patients in St. Louis, Denver, Boston, Baltimore, Galveston, Texas, and Farmington, Connecticut.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: TESTOSTERONE GEL GIVES WOMEN HOPE AFTER HIP FRACTURES
REPORT: MB #4633

BACKGROUND: Hip fractures most commonly occur from a fall or from a direct blow to the side of the hip. Some medical conditions such as osteoporosis, cancer, or stress injuries can weaken the bone and make the hip more susceptible to breaking. In severe cases, it is possible for the hip to break with the patient merely standing on the leg and twisting. Patients may be encouraged to get out of bed on the day following surgery with the assistance of a physical therapist. The amount of weight that is allowed on the injured leg will be determined by the surgeon and is generally a function of the type of fracture and repair. (Source: https://orthoinfo.aaos.org/en/diseases--conditions/hip-fractures)

RECOVERY: A hip fracture can change the rest of a patient's life, even after surgery and rehabilitation. According to the AARP, the year after fracturing a hip, 90 percent of those who needed no assistance climbing stairs before the fracture will not be able to climb five stairs; 66 percent won't be able to get on or off a toilet without help; 50 percent won't be able to raise themselves from a chair; 31 percent won't be able to get out of bed unassisted; and 20 percent won't be able to put on a pair of pants by themselves. Researchers are trying to change some of these statistics. (Source: https://www.aarp.org/health/conditions-treatments/info-10-2011/hip-fractures-survival.html)

NEW RESEARCH: Ellen Binder, MD, a Geriatrician at Washington University in St. Louis said, "Many years ago we did a large clinical trial looking at whether intensive and extended exercise in hip fracture patients would be beneficial relative to their mobility and their ability to do activities of daily living. And we demonstrated that compared to the usual kinds of exercises that patients do after they've finished their standard physical therapy that those that did intensive exercise that included weight training gained much more mobility and strength and ability to do activities of daily living." With a new study, Dr. Binder is looking at using testosterone combined with exercise, "We actually know from the world of sports where people have been using steroids for many years that it does enhance performance. And we think it's important to evaluate in women and particularly in women who are in a very weakened condition to see whether this can help to enhance their rehabilitation and essentially help jump start in conjunction with how quickly they recover." (Source: Ellen Binder, MD)