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“Introduction Osteoporosis is defined as “a skeletal disease characterized by loss of bone strength susceptible to increased risk of fracture”, which is frequent in women and the elderly [1]. According to the current WHO diagnostic criteria [2], the number of osteoporosis patients in USA is estimated to be 5.3 million [3], while the 2006 Japanese guideline estimates the number of Japanese patients as 7.8 to 11 million [4]. The objective of treating osteoporosis is to prevent the occurrence of fracture. Among the fractures Pifithrin-�� attributable to osteoporosis, hip fracture has the most important influence on survival, quality of life,

and medical costs. The worldwide incidence of hip fracture is expected to increase from approximately 1.5 million in 1990 to 4.5–6.3 million in 2050 [5, 6]. The number of hip fractures in Japan was estimated to be 148,100 in 2007, and this has increased every 2-hydroxyphytanoyl-CoA lyase year since the start of

investigation in 1987 [7]. Prior fracture is a risk factor for new fractures in addition to sex, age, and low bone mineral density (BMD) [8]. In particular, patients with a history of hip fracture may have an increased risk of unaffected side hip fracture because of excessive weight bearing on the opposite side while walking due to anxiety about recurrence. Current drug treatment for osteoporosis has made considerable progress. Risedronate is a bisphosphonate that is employed in patients with osteoporosis, which reduces bone resorption and bone turnover by inhibiting osteoclast activity [9]. Risedronate has been shown to increase BMD [10, 11], and to inhibit the occurrence of vertebral compression fractures [12, 13] as well as hip fractures [14, 15]. Based on such evidence, it is considered that risedronate is one of the most effective treatments for osteoporosis currently available [16]. Only a few studies on the efficacy of risedronate for inhibiting hip fracture in specific Japanese patient group have been performed so far [17, 18]. In addition, although patients with a history of hip fracture have a higher risk of new hip fractures, a study has not been conducted in this patient population. Accordingly, we conducted a prospective matched cohort study in Japanese osteoporosis patients with a history of hip fracture.