AI Article Synopsis
- The study investigates early signs of atypical femoral fractures (AFF) in patients receiving bisphosphonate (BP) treatment, focusing on how these signs might reverse before an actual fracture occurs.
- The researchers analyzed 102 patients diagnosed with incomplete atypical femoral fractures (IAFF) over a span of 12 years, categorizing them into three groups based on the severity of their condition.
- Key findings revealed that longer BP treatment periods and shorter cessation times increased the likelihood of fracture progression, while additional prophylactic treatments significantly influenced this outcome.
Article Abstract
Background: We found some important early findings in simple radiographs under the bisphosphonate (BP) treatment through a retrospective study. Here, we report the degree of reversibility of the early findings before overt fracture and analyze the factors affecting the differences through a retrospective case-control study.
Methods: We retrospectively inspected the clinical charts of patients diagnosed with atypical femoral fracture (AFF) at our institute between March 2006 and September 2018. Among the 209 screened patients, 102 patients were ultimately divided into 3 categories: Category 1 was described as endosteal diffuse flaring (EDF, early IAFF); category 2 was typical IAFF, with a tiny/partial crack that was limited to less than half of the thickness of the cortex; and category 3 was IAFF with a crack through the entire cortex. Demographics, clinical factors, and three categories of incomplete atypical femoral fracture (IAFF) were analyzed to determine whether their radiological condition "improved" or "progressed" after cessation of BP via univariate and multivariate analyses.
Results: Thirty-three, 53, and 16 were classified as categories 1, 2, and 3, respectively. Groups 1 and 2 consisted of 79 patients whose IAFF on the side of interest improved and 23 patients whose IAFF progressed, respectively. The uni/multivariate analyses of the groups demonstrated that the total period of BP (odds ratio [OR] = 1.49) and period of cessation of BP (OR = 0.24) were significant variables. In addition, prophylactic treatment for a contralateral IAFF was a strong factor for progression of the incomplete lesion on the side of interest (OR = 25.99). The rate of progression was significantly higher in patients with a mean treatment period of 43 months or longer, and in those with a mean cessation period shorter than 1.2 months.
Conclusion: Early-stage IAFF was found to be a unique finding in simple radiographs before the typical features of AFF. This EDF (category 1) was definitively reversible to normal bone when administration of BP was stopped. In addition, a long period of BP treatment and recent cessation of BP adversely affected IAFF with respect to spontaneous healing.
Level Of Evidence: Level III, a retrospective case-control study.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9123112 | PMC |
| http://dx.doi.org/10.1007/s43465-022-00639-y | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Comparative analysis of arterial involvement in predominant cranial and isolated extracranial phenotypes of giant cell arteritis using F-FDG PET-CT.
Arthritis Res Ther
December 2024
Department of Rheumatology, Hospital Universitario de Bellvitge. Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
Objective: To investigate differences in arterial involvement patterns on F-FDG PET-CT between predominant cranial and isolated extracranial phenotypes of giant cell arteritis (GCA).
Methods: A retrospective review of F-FDG PET-CT findings was conducted on 140 patients with confirmed GCA. The patients were divided into two groups: the cranial group, which presented craniofacial ischemic symptoms either at diagnosis or during follow-up, and the isolated extracranial group which never exhibited such manifestations.
Fibula flap reconstruction for maxillary stage 3 medication-related osteonecrosis of the jaw from recipient and donor site perspectives: a preliminary single-center study.
BMC Oral Health
December 2024
Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Background: While the surgical treatment of mandibular stage 3 medication-related osteonecrosis of the jaw (MRONJ) is well-documented, research on maxillary stage 3 MRONJ is limited. Antiresorptive medications can induce MRONJ and atypical femoral fracture (AFF), but their impact on the feasibility of using fibula flaps for reconstruction remains controversial. This study aimed to assess the surgical outcomes and functional recovery of fibula flap reconstruction for maxillary stage 3 MRONJ, considering both recipient and donor site outcomes.
View Article and Find Full Text PDFBilateral femoral neck fractures in pregnancy suggestive of transient osteoporosis of the hip in a patient with hyperparathyroidism: a case report.
Osteoporos Int
December 2024
Department of Orthopaedics, West Virginia University, PO Box 9196, Morgantown, WV, 26506, USA.
Atraumatic bilateral femoral neck fractures are rare, especially in younger patients and those without significant comorbidities. However, pregnant individuals appear to be at increased risk due to normal physiological changes in calcium balance, leading to transient osteoporosis of the hip. In these individuals, calcium and bone mineral density are generally decreased, reflecting the calcium demands of the developing fetus.
View Article and Find Full Text PDFUnusual radiographic progression of tumoral calcinosis along the anterior cruciate ligament in an adolescent male.
Proc (Bayl Univ Med Cent)
September 2024
Texas A&M University, Temple, Texas, USA.
A 13-year-old boy was referred to orthopedic surgery for chronic intermittent pain and swelling of the left knee. Initial imaging was consistent with osteochondritis dissecans of the femoral condyle. Follow-up imaging demonstrated unexpected progression, with a mass extending into the notch, replacing the anterior cruciate ligament, and eroding the femoral and tibial condyles.
View Article and Find Full Text PDFCharacteristics of femur morphology and proximal femur bone mineral density in Japanese females with bisphosphonate-related atypical femur fractures.
Skeletal Radiol
December 2024
Department of Orthopedic Surgery, Akita Hospital, 2-6-12 Takara, Chiryu City, Aichi, 472-0056, Japan.
Objective: To determine which parameters, including femur morphology, proximal femur bone mineral density, or patient characteristics, are associated with bisphosphonate-related atypical femur fractures (AFFs) and to investigate the relationships between AFF location and these parameters.
Materials And Methods: Sixteen females with a history of bisphosphonate use who presented with AFFs and 38 females without AFFs, even those with long-term bisphosphonate use of > 5 years, were compared. Patient characteristics; physique, gait ability, and history of pain and medication, were recorded.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!