Association of low-energy femoral fractures with prolonged bisphosphonate use: a case--control study

Excerpt

Lenart et al. have reported a retrospective case--control study of low-energy femoral fractures with prolonged bisphosphonate use in osteoporosis [1]. Long-term bisphosphonate therapy is thought to lead to profound suppression of bone turnover, increased microdamage accumulation, and alteration of bone tissue mineral properties as well as possibly bone tissue composition by altering collagen cross-linking, all of which can in turn cause brittleness of bone and propensity to fracture with minimal trauma [1]. Lenart et al. focussed their study on patients with postmenopausal osteoporosis, as the reported cases with this complication have been patients with osteoporosis treated with oral bisphosphonates [2‐4]. Therefore patients with active malignancy and bone metastases were excluded. Malignancy in fact was the most common reason for exclusion of patients with subtrochanteric/femoral shaft fractures, and multiple myeloma the most common malignancy. …