Wei J, Lane NE, Bolster MB, et al. - In this population-based cohort study, researchers intended to determine if there is a connection between tramadol and hip fracture risk. Among people age 50 years or older without a history of hip fracture, cancer, or opioid use disorder in The Health Improvement Network database in the United Kingdom general practice (2000–2017), five sequential propensity score–matched cohort studies were assembled, ie, candidates who started tramadol or those who received one of the following medications: codeine (n = 146,956) (another commonly used weak opioid), naproxen (n = 115,109) or ibuprofen (n = 107,438) (commonly used nonselective nonsteroidal anti-inflammatory drugs [NSAIDs]), celecoxib (n = 43,130), or etoricoxib (n = 27,689) (cyclooxygenase-2 inhibitors). According to findings, the initiation of tramadol was related to a higher risk of hip fracture compared with initiation of codeine and commonly used NSAIDs, indicating a call to revisit several guidelines on tramadol use in clinical practice.