Atypical femur fractures associated with bisphosphonates treatment: Retrospective single-center study

Abstract

Aim: Osteoporosis is a very common condition caused by an imbalance between bone production and resorption. The first-linetreatment of osteoporosis and the most commonly prescribed medication group is bisphosphonates. In recent years, severalresearches have reported that atypical femur fractures are seen following long term bisphosphonate usage. However, time of usageis not clearly defined yet. Our purpose of this study was to unveil the correlation between long term bisphosphonate usage andatypical femur fractures.Material and Methods: Patients with a history of bisphosphonates treatment with atypical femur fracture were retrospectivelyanalyzed. The collected data included patient demographics, the presence of trauma or history of the fracture, concomitant medicaldiagnoses, and history of bisphosphonates usage, type of bisphosphonates used, concomitant fractures, and other complicationsrelated to atypical femur fractures, mortalities.Results: Twenty-two patients were included. All patients were female, and the mean age was 79.36±8.71 (mean ± SD) years. Sixteenpatients were taking alendronate for an average of 6.81±2.74 (mean ± SD) years while six patients were taking ibandronate sustainedatypical femur fractures in a shorter time average of 4.66±1.49 (mean ±SD) years. Atypical femur fractures are started to be diagnosedafter 3 years of usage with having peak numbers in forth year.Conclusion: Our study supports correlation between long term bisphosphonates usage and atypical femur fractures as reported inseveral studies. In the use of long-term bisphosphonates more than 3 years, care should be taken for atypical femur fractures, withinvestigating prodromal symptoms and performing radiological imaging.