Atypical femur fracture after bisphosphonate therapy
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Keywords

Atypical femur fractures
Bisphosphonates
Osteoporosis
Alendronate

How to Cite

Gutiérrez-Zúñiga, D. ., González , E., & Arbeláez-Echeverri, P. (2021). Atypical femur fracture after bisphosphonate therapy. Revista Endocrino, 8(1). https://doi.org/10.53853/encr.8.1.696

Abstract

The changes in bone metabolism caused by osteoporosis, affect the micro-architecture of bone and predispose to fragility fractures that impact the quality of life and prognosis of millions of elderly patients. The current mainstay of treatment are bisphosphonates. With the increase in the use of bisphosphonates, physicians must be aware of their side effects. Although its pathophysiology is still debated and there is no clear causal relationship, there is an association between the chronic use of bisphosphonates and atypical fractures of the femur. We present the case of a patient with chronic use of alendronate for 10 years who develops an atypical subtrochanteric femur fracture, with previous imaging studies due to prodromal symptoms.

https://doi.org/10.53853/encr.8.1.696
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References

Odvina C, Zerwekh J, Rao D, Maalouf N, Gottschalk F, Pak C. Severely Suppressed Bone Turnover: A Potential Complication of Alendronate Therapy. The Journal of Clinical Endocrinology & Metabolism. 2005; 90(3):1294-1301.

https://doi.org/10.1210/jc.2004-0952

Edwards BJ, Bunta AD, Lane J, Odvina C, Rao DS, Raisch DW, et al. Bisphosphonates and Nonhealing Femoral Fractures: Analysis of the FDA Adverse Event Reporting System (FAERS) and International Safety Efforts. The Journal of Bone and Joint Surgery-American. 2013. Volume, 95(4):297-307.

https://doi.org/10.2106/JBJS.K.01181

Black DM, Abrahamsen B, Bouxsein ML, Einhorn T, Napoli N. Atypical Femur Fractures: Review of Epidemiology, Relationship to Bisphosphonates, Prevention, and Clinical Management. Endocrine Reviews 2018; 40(2), 333-368.

https://doi.org/10.1210/er.2018-00001

Schilcher J, Michaëlsson K, Aspenberg P.Bisphosphonate use and atypical fractures of the femoral shaft. N Engl J Med. 2011 May 5; 364(18):1728-37.

https://doi.org/10.1056/NEJMoa1010650

Saita Y, Ishijima M, Kaneko K. Atypical femoral fractures and bisphosphonate use: current evidence and clinical implications.

Feldstein, A, Black D, Perrin N, Rosales A, Friess D, Boardman D. et al. Incidence and demography of femur fractures with andwithout atypical features. J Bone Miner Res. 2012; 27:977-986.

https://doi.org/10.1002/jbmr.1550

Dell R, Adams A, Greene D, Funahashi T, Silverman S, Eisemon E. et al. Incidence of atypical nontraumatic diaphyseal fractures of the femur. J Bone Miner Res. 2012; 27: 2544-2550.

https://doi.org/10.1002/jbmr.1719

Black DM, Geiger EJ, Eastell R, Vittinghoff E, Li BH, Ryan DS, et al. Atypical Femur Fracture Risk versus Fragility Fracture Prevention with Bisphosphonates. New England Journal of Medicine. 2021; 383(8), 743-753. doi:10.1056/NEJMoa1916525

https://doi.org/10.1056/NEJMoa1916525

Lo JC, Neugebauer RS, Ettinger B. Risk of complete atypical femur fracture with Oral bisphosphonate exposure beyond three years. BMC Musculoskelet Disord 21, 801. 2020. https://doi.org/10.1186/s12891-020-03672-w

https://doi.org/10.1186/s12891-020-03672-w

Ott SM. In women, bisphosphonate use for ?3 years vs. <3 months was linked to increased atypical femur fracture risk. Ann Intern Med. 2021 Jan. 174(1):JC9. Epub 2021 Jan. 5. PMID: 33395342.

https://doi.org/10.7326/ACPJ202101190-009

Liu L, Li C, Yang P, Zhu J, Gan D, Bu L, et al. Association between alendronate and atypical femur fractures: a meta-analysis. Endocrine Connections. 2015; 4(1):58-64.

https://doi.org/10.1530/EC-14-0120

Allen MR. Skeletal accumulation of bisphosphonates: implications for osteoporosis treatment. Expert Opinion on Drug Metabolism & Toxicology. 2008; 4:1371-1378.

https://doi.org/10.1517/17425255.4.11.1371

Allen MR, Iwata K, Phipps R, Burr DB. Alterations in canine vertebral bone turnover, microdamage accumulation, and biomechanical properties following 1-year treatment with clinical treatment doses of risedronate or alendronate. Bone. 2006; 39:872-879.

https://doi.org/10.1016/j.bone.2006.04.028

Shane E, Burr D, Abrahamsen B, Adler RA, Brown TD, Cheung AM, et al. Atypical subtrochanteric and diaphyseal femoral fractures: Second report of a task force of the American society for bone and mineral research. J Bone Miner Res. 2014; 29:1-23.

https://doi.org/10.1002/jbmr.1998

Black JD, Kancherla VK, De Long WG. A review of atypical femoral fractures from a tertiary care teaching hospital: An alarming trend? J Orthop Trauma. 2016; 30:182-188.

https://doi.org/10.1097/BOT.0000000000000539

Feron JM, Cambon-Binder A. (2017). Medication management after intramedullary nailing of atypical fractures. Injury. 2017; 48, S15-S17.

https://doi.org/10.1016/j.injury.2017.04.030

Egol K, Park J, Prensky C, Rosenberg Z, Peck V, Tejwani N. Surgical treatment improves clinical and functional outcomes for patients who sustain incomplete bisphosphonate related femur fractures. J Orthop Trauma. 2013; 6:331-5.

https://doi.org/10.1097/BOT.0b013e31827240ae

Swiontkowski MF. Nonoperative versus Prophylactic Treatment of Bisphosphonate-associated Femoral Stress Fractures. Yearbook of Orthopedics. 2012. Pp. 51-52.

https://doi.org/10.1016/j.yort.2011.09.023

Githens M, Garner MR, Firoozabadi R. Surgical Management of Atypical Femur Fractures Associated With Bisphosphonate Therapy. J Am Acad Orthop Surg. 2018 Dec. 15; 26(24):864-871.

https://doi.org/10.5435/JAAOS-D-16-00717

Bogdan Y, Tornetta P, Einhorn TA, Guy P, Leveille L, Robinson J, et al. He aling Time and Complications in Operatively Treated Atypical Femur Fractures Associated With Bisphosphonate Use: A Multicenter Retrospective Cohort. J Orthop Trauma. 2016 Apr.; 30(4):177-81

https://doi.org/10.1097/BOT.0000000000000516

Zheng N, Tang N, Qin L. Atypical femoral fractures and current management. Journal of Orthopaedic Translation. 2016 7, 7-22.

https://doi.org/10.1016/j.jot.2016.06.029

Lu J, Maruo-Holledge M. Surgical Management of an Atypical Femoral Non-Union Fracture with Bone Morphogenic Protein Supplementation. Trauma Cases Rev. 2017; 3:048.

https://doi.org/10.23937/2469-5777/1510048

Shin WC, Moon NH, Jang JH, Seo HU, Suh KT. A retrospective bicenter comparative study of surgical outcomes of atypical femoral fracture: Potential effect of teriparatide on fracture healing and callus formation. Bone. 2019 Nov.; 128:115033.

https://doi.org/10.1016/j.bone.2019.08.006

Tsuchie H, Miyakoshi N, Iba K, Kasukawa Y, Nozaka K, Dohke T, et al. The effects of teriparatide on acceleration of bone healing following atypical femoral fracture: comparison between daily and weekly administration. Osteoporos Int. 2018 Dec.; 29(12):2659-2665.

https://doi.org/10.1007/s00198-018-4658-7

Yeh WL, Su CY, Chang CW, Chen CH, Fu TS, Chen LH, et al. Surgical outcome of atypical subtrochanteric and femoral fracture related to bisphosphonates use in osteoporotic patients with or without teriparatide treatment. BMC Musculoskelet Disord. 2017 Dec. 13; 18(1):527.

https://doi.org/10.1186/s12891-017-1878-5

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