{
  "abstract": "Background: Patients undergoing surgery for fragility hip fracture remain at high risk of refracture and poor functional recovery. This study compared the effects of commonly used anti-osteoporosis medications on postoperative outcomes.\n\nMethods: PubMed, Embase, Web of Science, and the Cochrane Library were searched from January 1, 2015, to April 15, 2026. Randomized and non-randomized comparative studies were eligible. Bayesian random-effects consistency-model network meta-analyses assessed refracture, hip bone mineral density expressed as g/cm ² or T-scores, Harris Hip Score, and visual analog scale scores. Leave-one-out sensitivity analyses were conducted for all outcomes. For HHS and VAS, RCT-only analyses were performed when the available RCTs formed connected networks, and analyses restricted to exactly 12 months of follow-up were conducted where feasible. The certainty of evidence was assessed using the GRADE approach.\n\nResults: Eighteen studies involving 2,414 patients were included. Comparative effects varied by outcome and follow-up duration, with no consistent evidence of treatment superiority. Ranking patterns suggested relatively favorable signals for ZOL and DEN in 12-month hip refracture, ZOL and ALN in 12-month overall refracture, and TPTD and DEN in 24-month overall refracture, but were interpreted as descriptive summaries. BMD ranking patterns varied according to reporting format, and no clear differences were found for BMD, HHS, or VAS. Leave-one-out sensitivity analyses showed broadly stable findings, and the additional RCT-only and exact 12-month analyses for HHS and VAS were generally consistent with the primary analyses. GRADE assessments indicated limited certainty of evidence across outcomes.\n\nConclusion: Anti-osteoporosis medications showed outcome- and time-specific efficacy patterns, but no consistent superiority was demonstrated. ZOL, DEN, and ALN showed relatively favorable signals for some early refracture outcomes, whereas TPTD showed a more favorable pattern for longer-term bone mass restoration. Given the limited and predominantly low-certainty evidence, these findings should be interpreted as contextual efficacy signals rather than treatment recommendations.\n\nSystematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261363237 , identifier CRD420261363237.",
  "abstract_shown": true,
  "affiliations": [
    "College of Chinese Medicine, Changchun University of Chinese Medicine",
    "Department of Orthopedics, Affiliated Hospital of Changchun University of Chinese Medicine",
    "Department of Orthopedics, Third Affiliated Hospital of Changchun University of Chinese Medicine"
  ],
  "article_type": "systematic review",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jingnan Tian"
    },
    {
      "affs": [
        0
      ],
      "name": "Hang Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuchi Lu"
    },
    {
      "affs": [
        1
      ],
      "name": "Hailong Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yan Lu"
    },
    {
      "affs": [
        1
      ],
      "name": "Dongxu Yu"
    },
    {
      "affs": [
        2
      ],
      "name": "Lianhe Yu"
    },
    {
      "affs": [
        1
      ],
      "name": "Zongjian Luo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1je3rt3mmg1e8.bib",
  "cited_by": 0,
  "doi": "10.3389/fendo.2026.1949781",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727487/?tool=EBI",
  "id": "1je3rt3mmg1e8",
  "issns": [
    "1664-2392"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fendo.2026.1949781/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Systematic Review"
    ],
    [
      "openalex",
      "2732|Bone health and osteoporosis research"
    ]
  ],
  "openalex": "W7223020704",
  "pdf_url": "https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2026.1949781/pdf",
  "pmcid": "PMC13727487",
  "pmid": "42978610",
  "published": "2026-10-20",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/1je3rt3mmg1e8.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:20Z",
      "native_id": "10.3389/fendo.2026.1949781",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fendo.2026.1949781/full"
    },
    {
      "first_seen": "2026-11-04T15:20:46Z",
      "native_id": "PMC:PMC13727487",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13727487"
    },
    {
      "first_seen": "2026-11-06T12:23:21Z",
      "native_id": "PMC13727487",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fendo.2026.1949781"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2732|Bone health and osteoporosis research",
      "subfield": "surgery"
    }
  ],
  "title": "Effects of different anti-osteoporosis medications on re-fracture risk, bone mineral density, and functional recovery following hip fragility fracture surgery: a systematic review and network meta-analysis",
  "title_text": "Effects of different anti-osteoporosis medications on re-fracture risk, bone mineral density, and functional recovery following hip fragility fracture surgery: a systematic review and network meta-analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:20:39Z",
  "url": "https://research.draconitic.com/paper/1je3rt3mmg1e8",
  "venue": "Frontiers in Endocrinology",
  "versions": []
}