Atypical femur fractures associated with bisphosphonate therapy: post-operative outcomes

Murphy, Benjamin; Francis, Sam L.; Rhee, Isaac; Babazadeh, Sina; Stoney, James D.; Stevens, Jarrad

doi:10.1007/s00590-022-03314-y

Cited by 2 publications

(2 citation statements)

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“…[49] It is also not certain presently if such findings are directly or indirectly involved in the outcomes leading to AFF risk, but a generalized effect of BP on bone quality must be entertained as potentially playing a role in the risk as it also appears to affect surgical outcomes in the treatment of patients with an AFF. [50] Based on the characteristics discussed above, it is clear that some clues are available that pertain to what may be looked for regarding possible mechanisms contributing to AFF risk. Of particular interest are the location-specific aspects, the bilaterality of the AFF, the fact that it requires being on the drugs for a long time, and the rarity of the AFF.…”

Section: Characteristics Of Aff and Those Patients At Riskmentioning

confidence: 99%

Section: Characteristics Of Aff and Those Patients At Riskmentioning

confidence: 99%

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Are secondary effects of bisphosphonates on the vascular system of bone contributing to increased risk for atypical femoral fractures in osteoporosis?

Hart

2023

BioEssays

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Osteoporosis (OP) is a bone disease which affects a number of post-menopausal females and puts many at risk for fractures. A large number of patients are taking bisphosphonates (BPs) to treat their OP and a rare complication is the development of atypical femoral fractures (AFF). No real explanations for the mechanisms underlying the basis for development of where AFF develop while on BPs has emerged.The present hypothesis will discuss the possibility that part of the risk for an AFF is a secondary effect of BPs on a subset of vascular cells in a genetically at-risk population, leading to localized deregulation of the endothelial cell (EC)-bone cell-matrix units in nutrient channels/canals of the femur and increased risk for AFF. This concept of targeting ECs is consistent with location of AFF in the femur, the bilateral risk for occurrence of AFF, and the requirement for long term exposure to the drugs.

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Section: Characteristics Of Aff and Those Patients At Riskmentioning

confidence: 99%

Section: Characteristics Of Aff and Those Patients At Riskmentioning

confidence: 99%