ArticleActa orthopaedica2015
Bisphosphonate-associated peri-implant fractures: a new clinical entity? A series of 10 patients with 11 fractures.
Article in Acta orthopaedica, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 32 citations in OpenAlex.
- Bisphosphonate-Related Pathological Femoral Fracture in a Child with ACTG2-Related Intestinal Failure and Metabolic Bone Disease: A Case Report.Journal of orthopaedic case reports · 2026Article
- Minimally Invasive Prophylactic Plating for Bisphosphonate-induced Atypical Femoral Fracture Post Total Hip Replacement.Journal of orthopaedic case reports · 2026Article
- Article
- Differences Between Atypical and Typical Subtrochanteric Fractures Due to Low-Energy Trauma.Cureus · 2025Article
- The definition of atypical femoral fractures should include periprosthetic femoral fractures (PAFFs).Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Surgical strategy of the treatment of atypical femoral fractures.World journal of orthopedics · 2023Review
- The histological assessment of new bone formation with zolendronic acid loaded bone allograft in rabbit femoral bone defect.Journal of medicine and life · 2023Article
- Peri-implant fractures of the upper and lower extremities: a case series of 61 fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022Article
- Bisphosphonates in Total Joint Arthroplasty: A Review of Their Use and Complications.Arthroplasty today · 2022Article
- Preventive bilateral femoral nailing in atypical femoral fracture non responder to anabolic therapy: case report and mini-review.Acta bio-medica : Atenei Parmensis · 2022Article
- Surveillance of atypical femoral fractures in a nationwide fracture register.Acta orthopaedica · 2022Article
- Plate osteosynthesis for atypical femoral fractures in patients with severely bowed femurs: comparing short versus long segment fixation - a case series.International journal of burns and trauma · 2022Review
- Precontoured Plate Fixation for Incomplete Atypical Diaphyseal Fracture of Femur using Three-Dimensional Printing Rapid Prototyping: Two Cases Reports.Orthopaedic surgery · 2021Article
- Atypical periprosthetic femoral fracture associated with long-term bisphosphonate therapy.Journal of orthopaedic surgery and research · 2020Article
- The Treatment of Acute Diaphyseal Long-bones Fractures with Orthobiologics and Pharmacological Interventions for Bone Healing Enhancement: A Systematic Review of Clinical Evidence.Bioengineering (Basel, Switzerland) · 2020Review
- Denosumab-Associated Peri-Implant Atypical Femur Fracture: A Case Report.Hawai'i journal of health & social welfare · 2019Article
- Bisphosphonate associated femoral stress fracture distal to an orthopaedic implant: They are predictable!Journal of clinical orthopaedics and trauma · 2019Article
- Lateral fixation: an alternative surgical approach in the prevention of complete atypical femoral fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2018Article
- Atypical femoral fractures in Italy: a retrospective analysis in a large urban emergency department during a 7-year period (2007-2013).Journal of bone and mineral metabolism · 2017Article
- Peri-implant Atypical Fractures Associated with Bisphosphonates: Should this Clinical Entity be Included in the Definition of Atypical Femoral Fracture? Case Report.Journal of orthopaedic case reportsArticle
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe current definition of atypical femoral fractures (AFFs) associated with bisphosphonate use includes only de novo fractures. However, in recent years reports of bisphosphonate-associated periprosthetic fractures involving stemmed arthroplasty implants have emerged. In a case series of peri-implant fractures in femurs with plate/screw constructs, we aimed to assess similarities with classical AFFs and how their location may have implications for the pathogenesis and management of AFFs. PATIENTS AND
methodsWe retrospectively identified 10 patients with 11 peri-implant fractures.
resultsThe patients were ambulant women, mean age 80 (70-92) years. Mean duration of bisphosphonate use was 5 (1-10) years. The peri-implant fractures were sustained an average of 4 years (6 months to 9 years) from the time of index surgery. They were all associated with low-energy mechanisms. 8 fractures occurred near the tip of a plate, while 3 traversed the penultimate screwhole of a plate. The peri-implant fractures showed clinical and radiological features of atypicality such as lateral cortical thickening, simple fracture pattern, and lack of comminution. The patients underwent revision surgery, with bone grafting used in all but 1 case. Radiological union was evident after 2-4 months.
interpretationAtypical peri-implant fractures of the femur associated with bisphosphonate use may be a new entity. Stress lesions and atypical fractures may tend to develop over stress risers along the operated femur. This finding has implications for the pathogenesis and clinical management of AFFs.
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