Bisphosphonate fractures as a cause of painful total hip arthroplasty.
نویسندگان
چکیده
Osteoporotic fractures pose a significant health concern for postmenopausal women. Bisphosphonate therapy has been shown to decrease the risk of these fractures. The bisphosphonate alendronate was approved by the US Food and Drug Administration for use in the United States in 1995, but questions have recently arisen concerning low-energy subtrochanteric femur fractures sustained by chronic users. Although no definitive association or causality between bisphosphonates and these fractures has been established, numerous cautionary reports exist concerning the duration of use and safety of alendronate in osteoporotic patients. This article reports 3 occurrences of bisphosphonate-associated atypical femur fractures as an etiology of periprosthetic hip pain in the total hip arthroplasty (THA) patient. These fractures are particularly concerning because these patients are often not advised to protect their weight bearing simply due to a painful THA and may sustain a catastrophic failure if not followed closely. Several theories have been suggested concerning the pathophysiology of atypical low-energy subtrochanteric fractures following bisphosphonate use. Each patient described in this article carried a diagnosis of rheumatoid arthritis and underwent chronic medical therapy; each patient experienced a delay in the diagnosis and onset of therapy due to low suspicion for bisphosphonate-associated fracture. This problem may become more common in the clinical setting; therefore, one must be vigilant and aware of this etiology of periprosthetic hip pain.
منابع مشابه
Bisphosphonate-Induced Periprosthetic Fracture: A Cause of Painful Total Hip Arthroplasty
Background. Cases have been reported in the literature of periprosthetic fractures associated with the use of bisphosphonates occurring in the long term following a Total Hip Replacement (THR). We report an interesting case of periprosthetic fracture secondary to bisphosphonate use only a few months after a THR. Case Report. A 72-year-old lady (on bisphosphonates for 10 years) underwent a THR f...
متن کاملAcetabular Insufficiency Fracture Following Prolonged Alendronate Use and the Failure of Total Hip Arthroplasty in “Frozen” Bone: Two Cases Report
Atypical insufficiency fracture of the femur following prolonged bisphosphonate use is well described. Regardless of the cause, insufficiency fracture of the acetabulum is extremely rare, and no reports have described insufficiency fractures of the acetabulum that are associated with prolonged bisphosphonate use. This report demonstrates the possibility of insufficiency fracture at the acetabul...
متن کاملProximal femoral reconstruction for failed internal fixation of a bisphosphonate-related femur fracture
We present a case of a bisphosphonate-related femur fracture in an elderly woman, who failed treatment with both cephalomedullary nail and proximal femoral locking plate, leading to successful treatment with total hip arthroplasty. Hardware failure should be included in the differential of patients with previous internal fixation of bisphosphonate-related femur fracture that present with hip or...
متن کاملIn-Hospital Outcomes after Hemiarthroplasty versus Total Hip Arthroplasty for Isolated Femoral Neck Fractures
Background: Previous studies suggest total hip arthroplasty may have some benefits compared to hemi-arthroplasty for displaced intracapsular femoral neck fractures in patients more than 60 years of age. The primary research question of our study was whether in-hospital adverse events, post-operative length of stay (LOS) and mortality in patients 60 year of age or older differed between tot...
متن کاملEconomic Analysis of Bisphosphonate Use after Distal Radius Fracture for Prevention of Hip Fracture
Background: Osteoporosis is a common condition among the elderly population, and is associated with an increased risk of fracture. One of the most common fragility fractures involve the distal radius, and are associated with risk of subsequent fragility fracture. Early treatment with bisphosphonates has been suggested to decrease the population hip fracture burden. However, there have been no p...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Orthopedics
دوره 34 12 شماره
صفحات -
تاریخ انتشار 2011