Atypical Femoral fractures: A Review of the Literature

Desai, Pingal; Vyas, Parth; Lane, Joseph M.

doi:10.1007/s11914-013-0167-y

Cited by 23 publications

(14 citation statements)

References 60 publications

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“…Table includes the surgical description for reported cases. These remaining incomplete fractures were managed with conservative measures such as making them non–weight bearing, an intervention that has proven effective in other institutions . Prophylactic rodding was not performed at MD Anderson.…”

Section: Resultsmentioning

confidence: 99%

Incidence of Atypical Femur Fractures in Cancer Patients: The MD Anderson Cancer Center Experience

Edwards

Sun

West

et al. 2016

Journal of Bone and Mineral Research

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Atypical femoral fractures (AFFs) are rare adverse events attributed to bisphosphonate (BP) use. Few cases of AFF in cancer have been described; the aim of this study is to identify the incidence and risk factors for AFF in a large cancer center. This retrospective study was conducted at the MD Anderson Cancer Center. The incidence rate of AFF among BP users was calculated from January 1, 2004 through December 31, 2013. The control group (n = 51) included 2 or 3 patients on BPs matched for age (≤1 year) and gender. Logistic regression analysis was used to assess the relationship between clinical characteristics and AFF. Twenty-three AFF cases were identified radiographically among 10,587 BP users, the total BP exposure was 53,789 months (4482 years), and the incidence of AFF in BP users was 0.05 cases per 100,000 person-years. Meanwhile, among 300,553 patients who did not receive BPs there were 2 cases of AFF as compared with the 23 cases noted above. The odds ratio (OR) of having AFF in BP users was 355.58 times higher (95% CI, 84.1 to 1501.4, p < 0.0001) than the risk in non-BP users. The OR of having AFF in alendronate users was 5.54 times greater (OR 5.54 [95% CI, 1.60 to 19.112, p = 0.007]) than the odds of having AFF among other BP users. Patients who were on zoledronic acid (ZOL) had smaller odds of developing AFF compared with other BP users in this matched case control sample. AFFs are rare, serious adverse events that occur in patients with cancer who receive BP therapy. Patients with cancer who receive BPs for prior osteoporosis therapy or for metastatic cancer are at higher risk of AFF. © 2016 American Society for Bone and Mineral Research.

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Section: Resultsmentioning

confidence: 99%

Incidence of Atypical Femur Fractures in Cancer Patients: The MD Anderson Cancer Center Experience

Edwards

Sun

West

et al. 2016

Journal of Bone and Mineral Research

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“…Consideration should include individual fracture risk and potential medication-related adverse effects. There is concern regarding long-term use of bisphosphonates and the association with atypical femur fractures207 208 and osteonecrosis of the jaw 209. In addition, there are no published studies of bisphosphonate use in exercising and athletic women with Triad disorders.…”

Section: Pharmacological Treatment Strategies For the Clinical Sequelmentioning

confidence: 99%

2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013

et al. 2014

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The Female Athlete Triad is a medical condition often observed in physically active girls and women, and involves three components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction and (3) low bone mineral density. Female athletes often present with one or more of the three Triad components, and an early intervention is essential to prevent its progression to serious endpoints that include clinical eating disorders, amenorrhoea and osteoporosis. This consensus statement represents a set of recommendations developed following the 1st (San Francisco, California, USA) and 2nd (Indianapolis, Indiana, USA) International Symposia on the Female Athlete Triad. It is intended to provide clinical guidelines for physicians, athletic trainers and other healthcare providers for the screening, diagnosis and treatment of the Female Athlete Triad and to provide clear recommendations for return to play. The 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad expert panel has proposed a risk stratification point system that takes into account magnitude of risk to assist the physician in decision-making regarding sport participation, clearance and return to play. Guidelines are offered for clearance categories, management by a multidisciplinary team and implementation of treatment contracts. This consensus paper has been endorsed by the Female Athlete Triad Coalition, an International Consortium of leading Triad researchers, physicians and other healthcare professionals, the American College of Sports Medicine and the American Medical Society for Sports Medicine.

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“…Although there is an initial decrease in the overall fracture risk with bisphosphonate therapy, with evidence to suggest improved bone mineral density and decreased revision rate after total joint arthroplasty, long-term therapy with these medications are associated with atypical femoral fractures, and patients need to be monitored carefully. 37 In this case, the patient was taking ibandronate prior to his revision THA, though it was discontinued more than 1 year prior to surgery. Due to the rare incidence of the disease, no studies have looked at the effect of bisphosphonate therapy on joint arthroplasty in patients with OI, but there is potential benefit for use of this therapy in the surgical setting.…”

Section: Discussionmentioning

confidence: 98%

Revision Total Hip Arthroplasty in Osteogenesis Imperfecta

Schoof

Duenes

Feng

et al. 2020

The Journal of Hip Surgery

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Osteogenesis imperfecta (OI) is a rare group of connective tissue disorders commonly associated with bone fragility, deformity, and fractures, leading to instability and early osteoarthritis. Current advancements in the medical and surgical management of OI have extended the life span of these patients, resulting in an increased need for joint arthroplasty to help maintain quality of life. However, surgery among this patient population is technically challenging and comes with a high burden of revision. In this report, we present a case of revision total hip arthroplasty in a patient with OI and review important considerations to help ensure proper preoperative planning and correct precautions to minimize complications and decrease implant failure.

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Atypical Femoral fractures: A Review of the Literature

Cited by 23 publications

References 60 publications

Incidence of Atypical Femur Fractures in Cancer Patients: The MD Anderson Cancer Center Experience

Incidence of Atypical Femur Fractures in Cancer Patients: The MD Anderson Cancer Center Experience

2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013

Revision Total Hip Arthroplasty in Osteogenesis Imperfecta

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