To the Editor: The long-term safety of bisphosphonates for thetreatment of osteoporosis has been questioned. Two case serieshave suggested a link between prolonged bisphosphonate therapyand atypical fractures. In one series, a small number of patientssustained low-energy nonvertebral fractures while receivinglong-term alendronate therapy; three were fractures of the femoralshaft.1 Bone biopsies in these patients showed evidence of severelysuppressed bone turnover and fracture healing that was delayedor absent. In the other series, low-energy subtrochanteric fractureswere found in nine women who had been receiving long-term alendronatetherapy.2 Theoretically, bisphosphonates suppress bone turnoverand thus . . . [Full Text of this Article]
Maher, S. A., Hidaka, C., Cunningham, M. E., Rodeo, S. A.
(2008). What's New in Orthopaedic Research. JBJS
90: 1800-1808
[Full Text]
Kwek, E. B.K., Koh, J. S.B., Howe, T. S., Lee, P., Seibel, M. J., Lenart, B. A., Lorich, D. G., Lane, J. M.
(2008). More on Atypical Fractures of the Femoral Diaphysis. NEJM
359: 316-318
[Full Text]