Katelin Isakoff

All Publications

• Under-prescribed and underutilized: National trends in osteoporosis medication use after fragility fracture. Bone Wadhwa, H., Isakoff, K. J., Pham, N. S., Goodnough, L. H., Bishop, J. A., Gardner, M. J. 2026: 117835

  Abstract

  Fragility fractures are common among older adults with osteoporosis, yet most patients do not receive recommended treatment. Prescribing trends in the US after fragility fractures and patient-level predictors of medication prescription remain unclear. This study evaluates prescribing patterns and predictive factors of osteoporosis medication prescription after fragility fracture to identify gaps in secondary prevention and guide future interventions.Using a commercial claims database (Merative™ MarketScan®), adult patients over 50 with a new fragility fracture from 2015 to 2022 were retrospectively reviewed. Fragility fractures were defined as hip, vertebral compression (VCF), or distal radius fractures (DRF) without concomitant injuries that would be present in a higher energy mechanism. Patients with prior osteoporosis diagnosis or treatment were excluded. The primary outcome was osteoporosis medication prescription within 90 days post-fracture, categorized as bisphosphonate, non-bisphosphonate antiresorptive, or anabolic agent. Multivariable logistic regression identified factors associated with overall prescription and medication class.Among 53,679 patients with a fragility fracture (mean age 75.1; 62.3% female), only 7.7% were prescribed osteoporosis medication within 90 days of a fragility fracture. Of those treated, 68.8% received bisphosphonates, 26.4% non-bisphosphonate antiresorptives, and 11.1% anabolic agents. The only anabolic agent prescribed was teriparatide. Osteoporosis medication prescription declined over the study period.Only 8% of patients with fragility fractures receive osteoporosis medication, with bisphosphonates most commonly prescribed. Anabolic therapies are rarely used, despite evidence supporting their efficacy. Additional resources should be dedicated to improving secondary fracture prevention with pharmacological therapy, particularly among older adults and those with comorbidities.

  View details for DOI 10.1016/j.bone.2026.117835

  View details for PubMedID 41690441

• Outcomes of delayed arthroplasty after failed nonoperative management of valgus-impacted femoral neck fractures are comparable with outcomes of acute arthroplasty. Journal of orthopaedic trauma Isakoff, K. J., Tedesco, C. L., Wadhwa, H., Wong, H. J., Koltsov, J. C., Gardner, M. J., Bishop, J. A., Goodnough, L. H. 2025

  Abstract

  To compare surgical complication rates between delayed arthroplasty after failed nonoperative management and acute arthroplasty for valgus-impacted geriatric femoral neck fractures.Design: Retrospective review.Single academic Level I trauma center.Patients over 65 with valgus-impacted femoral neck fractures (AO/OTA 31-B1) from 2005-2024 treated with acute or delayed arthroplasty were retrospectively reviewed. Arthroplasty was considered delayed on or after day 7 of attempted nonoperative management.Outcome Measures and Comparisons: Postoperative complication rates, reoperations, and failure to return to baseline ambulatory status at final follow-up were assessed. Differences in patient demographics and outcomes between acute and delayed arthroplasty patients were assessed with chi-squared, Fisher's exact, and independent samples t-tests (α=0.05).There were 47 patients treated with acute arthroplasty [35 (74.5%) female, age 83.5± 2 years, CCI: 6.0, 40% independent weight-bearing, follow-up: 8.5 months] and 21 treated with delayed arthroplasty [16 (76.2%) female, age 82.1±4 years, CCI: 6.1, 60% independent weight-bearing, follow-up: 10.1 months]. Rates of medical [acute: 12 (25.5%), delayed: 3 (14.3%); p = 0.361] and surgical [acute: 5 (10.6%), delayed: 2 (9.5%); p = 0.999] complications did not differ between groups. The proportion of patients who did not return to baseline ambulatory status [acute: 14 (32.6%), delayed: 5 (26.3%); p = 0.847] and reoperation rates [acute: 2 (4.3%), delayed: 0 (0%); p = 0.999] were similar between groups. The postoperative mortality rate was 19.1% among the patients treated with acute arthroplasty and 19.0% among those treated with delayed arthroplasty, with no difference between groups (p = 0.999).There were no differences in postoperative complications, reoperations, failure of return to baseline ambulatory status, or mortality for geriatric patients who underwent delayed versus acute arthroplasty for valgus-impacted femoral neck fractures. There was no evidence of increased surgical morbidity in geriatric valgus-impacted femoral neck fractures after failed nonoperative management compared to patients treated with acute arthroplasty.Level III.

  View details for DOI 10.1097/BOT.0000000000003139

  View details for PubMedID 41397152

• HPV vaccine behaviors and intentions among a diverse sample of women aged 27-45 years: implications for shared clinical decision-making. BMC public health Allen, J. D., Abuelezam, N. N., Rose, R., Isakoff, K., Zimet, G., Fontenot, H. B. 2024; 24 (1): 2154

  Abstract

  The Advisory Committee on Immunization Practices issued a shared clinical decision-making (SCDM) recommendation for HPV vaccination in persons aged 27-45. Since expanded eligibility for the vaccine was issued, little information has been available about HPV vaccine behaviors and intentions among women in this age group.We conducted a cross-sectional online survey among women aged 27-45 years recruited through a Qualtrics™ respondent panel (N = 324) to answer the following questions (1) What is the prevalence of HPV vaccination among a diverse sample of adult women aged 27-45 years? (2) What are the characteristics of those who have or have not previously been vaccinated? and (3) What factors are associated with the intention to obtain the HPV vaccine among those who had never been vaccinated? Multivariable logistic regression analyses estimated adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs).Only 31.1% had at least one dose of the HPV vaccine. In multivariable analyses, those more likely to have been vaccinated were younger and were more likely to believe that the vaccine was effective. Of those unvaccinated or unsure, 54.8% indicated they were likely to get vaccinated in the future. Factors associated with future vaccine intention (compared to those not intending) included beliefs about vaccine testing, perceived likelihood of HPV infection, greater comfort in asking one's provider for vaccination, and prior negative healthcare experiences.Our findings suggest that many women in this age group are interested in HPV vaccination. While the recommendation is for SCDM rather than routine vaccination for all women in this age group, efforts to promote informed decision-making among mid-adult women may include educating women about the rigorous vaccine testing and approval process, their risk factors for HPV infection, and encouraging them to engage in SCDM with their medical providers. Targeted efforts to reach women who have had negative experiences with healthcare may also be needed.

  View details for DOI 10.1186/s12889-024-18740-2

  View details for PubMedID 39118089

  View details for PubMedCentralID PMC11308683