Study: Device may prevent broken hips

By Janet McConnaughey, Associated Press writer

Frail elderly people are much less likely to break their hips in falls if they wear hard-shelled hip protectors, a study has found -- good news for aging baby boomers throughout the country.

An estimated 250,000 people break their hips every year in the United States, and the National Institutes of Health predict that an aging population will push that to 650,000 by midcentury.

About 10 different hip protectors are on the market, including a Finnish one described by Dr. Pekka Kannus, one of the designers, in today's New England Journal of Medicine.

His study of 1,801 people, aged 75 to 87, is the largest so far in a field that is burgeoning worldwide.

"The market is very wild, without any evidence that they are protective," said Kannus, of Tampere University Medical School and Hospital in Tampere, Finland. He said he has some financial stake in the KPH2 hip shield because he will receive a small grant if the manufacturer becomes profitable.

Several other protectors have gone through clinical studies, some with 650 to 750 patients. More studies, some involving thousands of patients, are under way around the world, including Ireland, Canada, New Zealand and England.

In Kannus' study, health care centers randomly assigned KPH2 protectors to 653 elderly patients at risk of breaking their hips. The study's biggest problem was that 31 percent of the test group refused to wear the pads all day, every day, Kannus said.

At the end of the two-year study, 13 of the 653 broke their hips, nine of them when they weren't wearing the shields. In comparison, there were 67 breaks among 1,148 patients in the control group.

In all, 1,034 falls were logged for patients wearing hip shields, and 370 falls while test group members were not wearing them.

Kannus did not report the total number of falls in the comparison group.

Dr. Robert D'Ambrosia, a surgeon at Louisiana State University Health Sciences Center and past president of the American Academy of Orthopedic Surgeons, said Kannus' study was the first rigorous major study he has seen. He expects to see more hip protectors used in the coming year.

"This Finnish study really shows that it makes a difference. If you can prevent one of these fractures from occurring, it's a lot better than trying to fix it afterward," he said.

Broken hips are becoming more of a problem every year as baby boomers age in the United States and life expectancy rises in developing countries.

In this country, 20 percent of all hip fracture patients die within a year, and only one-quarter of hip fracture patients make a full recovery, according to the AAOS. It says half need a cane or walker, and 40 percent go from the hospital to a nursing home.

Worldwide, 1.7 million people broke hips weakened by osteoporosis in 1990, and the number is expected to hit 6.3 million by 2050, according to the World Health Organization.

D'Ambrosia said he expects the AAOS to evaluate different kinds of hip protectors, which vary widely. Those on the market include some like Kannus', with pads of varying thickness; pads without hard plastic shields, and shields without pads. Some pads are foam, rubber or gel; others enclose air and even a mixture of cornstarch and water.

Some are sewn into elasticized undergarments, some are fitted into pockets, some are sewn into loose boxer-type shorts, and at least one is attached to a belt which can be worn under or over clothing.

One, made in Denmark and sold in this country, cost $90 for a "kit:" three sets of underwear and one pair of hip protectors. An Australian manufacturer charges about $77 for an equivalent set.

None of the manufacturers claim their product will prevent all broken hips, noting that consumers must do everything possible to prevent falls and osteoporosis.

Kannus said he himself has worn the KPH2 for days at a time. He was aware of protectors at first, but got used to them, as people get used to bicycle helmets.

"There were some times when even I forgot I was wearing them," he said.

"If you don't show it to people, they don't know you are using these hip protectors under your clothing."

On the Web:

World Health Organization about hip fractures: ">http://www.who.int/inf-pr-1999/en/pr99-58.html

Hip information from American Academy of Orthopedic Surgeons: ">http://orthoinfo.aaos.org/category.cfm?topcategoryHip

University of Tampere Medical School (English page): ">http://www.uta.fi/laitokset/bio/index--en.html

Some earlier studies: ">http://www.hindso.suite.dk/

Irish study: ">http://www.qub.ac.uk/nur/staff/ohallor.html

National Center for Injury Prevention and Control: http://www.cdc.gov/ncipc/

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