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If you know anyone who has broken a hip, you know how traumatic the injury can be.

Every year more than 300,000 people over age 65 are hospitalized after hip fractures, according to the Centers for Disease Control. One in four are women, who may have weak, brittle bones because of osteoporosis.

Furthermore, up to 75% of people who break a hip never fully recover. “It’s a sentinel event,” said Dr. Denise Orwig of the University of Maryland, Baltimore.

“There are significant changes in body composition after a hip fracture. They have a decline in bone mineral density, an increase in fat mass and a decrease in muscle mass or lean body mass,” Orwig said.

Researchers are now seeking women 65 and older who have fractured a hip in the past four months. They want to see if the addition of a low dose of testosterone might help in the recovery process.

“Testosterone is an anabolic steroid that has tremendous potential to increase muscle mass,” Orwig said.

The randomized, controlled, double-blind trial is called Starting a Testosterone and Exercise Program after Hip Injury (STEP-HI), and is funded by the National Institute on Aging. The lead principal investigator is located at the Washington University School of Medicine.

Orwig, who is director of the Baltimore Hip Studies, a research program “dedicated to optimizing recovery from hip fracture,” is overseeing the trial in the Baltimore area, along with Dr. Adrian Dobs at Johns Hopkins University. Baltimore is one of seven clinical sites doing the study across the U.S.

What the study entails

Once enrolled, participants will randomly be placed into one of three study groups. One group will receive standard enhanced usual care after hip fracture, making monthly visits to the research center.

Another group will begin a personalized six-month exercise program and will receive a placebo gel to apply to their skin. They’ll meet with an exercise physiologist and/or physical therapist twice a week to do supervised exercises.

The third group will do the same exercises twice a week for six months, but they will be given a gel that contains a low dose of hormonal therapy. The hormonal therapy used is testosterone.

All three branches of the study can benefit patients, Orwig said. “Exercise alone is a very powerful intervention.”

Despite the side effects of anabolic hormone steroids (aggression, liver disease, etc.), a low dose is not likely to cause problems in women, Orwig said.

“We don’t really have to worry about some of the more serious side effects we’ve seen in men,” she said. “We don’t expect to see them in women.”

Participants must live in the community within a 30-mile radius of Loch Raven VA Medical Center, located on the Alameda in Baltimore. All transportation to and from the VA Loch Raven facility will be provided by the research center, which utilizes Lyft.

For more information or to volunteer to enroll in the STEP-HI study, call (410) 706-5144, email cwade@som.umaryland.edu or visit stephistudy.wustl.edu.