ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2009
Association of low-energy femoral fractures with prolonged bisphosphonate use: a case control study.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 136 papers, 7 of them syntheses that pooled it.
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Who cites it
136 citing papers in PubMed, 7 syntheses or guidelines pooled it, 384 citations in OpenAlex.
- The Genetics of Atypical Femur Fractures-a Systematic Review.Current osteoporosis reports · 2021Pooled it
- The effects of weight loss approaches on bone mineral density in adults: a systematic review and meta-analysis of randomized controlled trials.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016Pooled it
- Bisphosphonates and risk of subtrochanteric, femoral shaft, and atypical femur fracture: sensitivity and trim and fill studies.Genetic testing and molecular biomarkers · 2014Pooled it
- Bisphosphonates and risk of subtrochanteric, femoral shaft, and atypical femur fracture: a systematic review and meta-analysis.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2013Pooled it
- Bisphosphonates and nonhealing femoral fractures: analysis of the FDA Adverse Event Reporting System (FAERS) and international safety efforts: a systematic review from the Research on Adverse Drug Events And Reports (RADAR) project.The Journal of bone and joint surgery. American volume · 2013Pooled it
- Osteoporosis drug therapy strategies in the setting of disease-modifying agents for autoimmune disease.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2013Pooled it
- Fracture prevention in postmenopausal women.BMJ clinical evidence · 2011Pooled it
- Assessing the feasibility of the Effectiveness of Discontinuing Bisphosphonates trial: a pilot study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Trial
- Risk communication methods in hip fracture prevention: a randomised trial in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Trial
- Association between femoral localized cortical thickening ("beaking" or "flaring") and bisphosphonate duration in glucocorticoid-induced osteoporosis.Journal of bone and mineral metabolism · 2026Article
- Non-union after bisphosphonate-associated atypical femoral fractures: a review of the current literature.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Review
- Asian Federation of Osteoporosis Societies 2025 consensus on atypical femoral fractures in patients with osteoporosis.Osteoporosis and sarcopenia · 2025Review
- Atypical Periprosthetic Femoral Fracture Might be Considered a Distinct Subtype of Atypical Femoral Fracture: A Retrospective Study.Orthopaedic surgery · 2024Article
- Article
- Prevalence and risk factors for atypical femoral fracture among Lebanese patients with hip and shaft fractures.JBMR plus · 2024Article
- Review
- Review
- Multicenter study on atypical femoral fractures in patients with bone metastases taking bone- modifying agents.Journal of bone oncology · 2023Article
- Article
- Fecal microbiota transplantation as a promising treatment option for osteoporosis.Journal of bone and mineral metabolism · 2022Review
76 more citing papers are in PubMed but not listed here.
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
summaryRecent evidence has linked long-term bisphosphonate use with insufficiency fractures of the femur in postmenopausal women. In this case-control study, we have identified a significant association between a unique fracture of the femoral shaft, a transverse fracture in an area of thickened cortices, and long-term bisphosphonate use. Further studies are warranted.
introductionAlthough clinical trials confirm the anti-fracture efficacy of bisphosphonates over 3-5 years, the long-term effects of bisphosphonate use on bone metabolism are unknown. Femoral insufficiency fractures in patients on prolonged treatment have been reported.
methodsWe performed a retrospective case-control study of postmenopausal women who presented with low-energy femoral fractures from 2000 to 2007. Forty-one subtrochanteric and femoral shaft fracture cases were identified and matched by age, race, and body mass index to one intertrochanteric and femoral neck fracture each.
resultsBisphosphonate use was observed in 15 of the 41 subtrochanteric/shaft cases, compared to nine of the 82 intertrochanteric/femoral neck controls (Mantel-Haenszel odds ratio (OR), 4.44 [95% confidence interval (CI) 1.77-11.35]; P = 0.002). A common X-ray pattern was identified in ten of the 15 subtrochanteric/shaft cases on a bisphosphonate. This X-ray pattern was highly associated with bisphosphonate use (OR, 15.33 [95% CI 3.06-76.90]; P < 0.001). Duration of bisphosphonate use was longer in subtrochanteric/shaft cases compared to both hip fracture controls groups (P = 0.001).
conclusionsWe found a significantly greater proportion of patients with subtrochanteric/shaft fractures to be on long-term bisphosphonates than intertrochanteric/femoral neck fractures. Bisphosphonate use was highly associated with a unique X-ray pattern. Further studies are warranted.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.