Impending atypical femoral fractures associated with bisphosphonates: postoperative diagnosis after hip prosthesis. Clinical cases presentation.

Main Article Content

Vanna Bottai
Nicola Piolanti
Giuseppe Digrandi
Agnese Menconi
Damiano Antognetti
Michele Di Lonardo
Michelangelo Scaglione
Gloria Raffaetà

Keywords

Osteoporosis, Atypical femoral fractures, Hip Prosthesis, Periprosthetic Atypical Femoral Fractures, Bisphosphonates

Abstract

Background and aim: Number of hip prosthesis implants in arthritis, number of patients treated with bisphosphonates to prevent fragility fractures and, together, number of atypical femoral fracture’s cases are increasing.


Case series: This article describes two cases of hip arthritis, treated with hip replacement, in patients using bisphosphonates for a long time; in both cases an incomplete atypical femoral fracture was misdiagnosed before the surgery. Authors describe the importance to carry out a complete osteometabolic and radiographic pre-operative examination of patients in treatment with bisphosphonates going to hip replacement, to check the possible presence of incomplete atypical femoral fracture and to optimize surgical and pharmacological treatment.


Conclusions: In hip prosthesis surgery, prior diagnosis of incomplete atypical femoral fractures can indicate the choice of a different kind of prosthesis stem to optimize surgical results. This can also positively impact to rehabilitation in term of duration and daily activities recovery.  

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References

1. Shane E, Burr D, Abrahamsen B, et al. Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2014 Jan;29(1):1–23.

2. Meling T, Nawab A, Harboe K, et al. Atypical femoral fractures in elderly women: a fracture registry-based cohort study.
Bone Joint J. 2014 Aug;96-B(8):1035–1040.

3. Bottai V, De Paola G, Celli F, et al. Histological study of atraumatic periprosthetic fractures: does atypical periprosthetic fracture exist?
Clin Cases Miner Bone Metab. 2017 May-Aug;14(2):136-139.

4. Robinson Jde D, Leighton RK, Trask K, et al. Periprosthetic atypical femoral fractures in patients on long-term bisphosphonates: a multicenter retrospective review. J Orthop Trauma. 2016 Apr;30(4):170–176.

5. Huang TW, Wang CJ, Shih HN, et al. Bone turnover and periprosthetic bone loss after cementless total hip arthroplasty can be restored by zoledronic acid: a prospective, randomized, open-label, controlled trial. BMC Musculoskelet Disord. 2017 May 22;18(1):209.

6. Taormina DP, Marcano Al, Karia R, et al. Symptomatic atypical femoral fractures are related to underlying hip geometry.
Bone. 2014 Jun;63:1-6.

7. Hagen JE, Miller AN, Ott SM, et al. Association of atypical femoral fractures with bisphosphonate use by patients with varus hip geometry. J Bone Joint Surg Am. 2014 Nov 19;96(22):1905-1909.

8. Mondanelli N, Facchini A, Troiano E, et al. Periprosthetic Atypical Femoral Fractures Exist: A Retrospective Study at a Single Institution. Prevalence on 115 Periprosthetic Femoral Fractures Around a Primary Hip Stem. Arthroplasty. 2021 jun;36(6):2189-2196.

9. Lee YK, Park CH, Kim KC, et al. Frequency and associated factor of atypical periprosthetic femoral fracture after hip arthroplasty.
Injury. 2018 Dec;49(12):2264-2268.

10. Bottai V, Dell'Osso G, Celli F, et al. Total hip replacement in osteoarthritis: the role of bone metabolism and its complications.
Clin Cases Miner Bone Metab. 2015 Sep-Dec;12(3):247-50.

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