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01-06-2014 | Biomechanics (M Silva and P Zysset, Section Editors)

Atypical Femoral Fractures, Bisphosphonates, and Mechanical Stress

Authors: Per Aspenberg, Jörg Schilcher

Published in: Current Osteoporosis Reports | Issue 2/2014

Abstract

Atypical fractures are stress fractures occurring in the femoral shaft and closely related to bisphosphonate use. We here discuss their radiographic definition and different putative etiologies, apart from mechanical stress. Long time reduction of skeletal remodeling because of bisphosphonate use is thought to allow time for the bone to deteriorate mechanically, resulting in reduced toughness. However, the risk of atypical fracture diminishes rapidly after cessation of treatment, which suggests more acute effects of bisphosphonate use. Microdamage normally accumulates at areas of high stress. Possibly, ongoing bisphosphonate use reduces the ability to resorb and replace areas of microdamage by targeted remodeling. This could lead to crack propagation beyond a point of no return, ending in macroscopic stress fracture.

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Title: Atypical Femoral Fractures, Bisphosphonates, and Mechanical Stress
Authors: Per Aspenberg
Jörg Schilcher
Publication date: 01-06-2014
Publisher: Springer US
Published in: Current Osteoporosis Reports / Issue 2/2014
Print ISSN: 1544-1873
Electronic ISSN: 1544-2241
DOI: https://doi.org/10.1007/s11914-014-0200-9

At a glance: The STEP trials

Springer Medicine

Atypical Femoral Fractures, Bisphosphonates, and Mechanical Stress

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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