Effect of Severe Bowing in Bisphosphonate-Related Atypical Femoral Fracture.

IF 1.9 2区 医学 Q2 ORTHOPEDICS
Clinics in Orthopedic Surgery Pub Date : 2025-04-01 Epub Date: 2025-02-18 DOI:10.4055/cios24103
Jung-Wee Park, Young-Kyun Lee, Young-Seung Ko, Seong-Eun Byun, Young-Ho Cho, Kyung-Hoi Koo
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引用次数: 0

Abstract

Backgroud: Long-term use of bisphosphonate is a risk factor for atypical femoral fractures (AFFs). Femoral bowing is known to be associated with AFFs. However, whether femoral bowing quickens the occurrence of AFF is unknown. The purpose of this study was to determine whether AFF occurs earlier in patients with severe femoral bowing than in those without severe bowing.

Methods: One hundred and sixty-four patients (186 AFFs) from January 2006 to December 2022 were included in this study. According to severity of femoral bowing, patients were divided into 2 groups: severe bowing group (26 femurs) and minimal to moderate bowing group (160 femurs). Age, sex, and completeness and location of AFF were compared between the 2 groups. We compared the time of AFF occurrence after bisphosphonate therapy using cumulative percentage between the 2 groups.

Results: Age and sex were similar between the 2 groups, while body mass index (BMI) was lower (22.5 ± 3.0 kg/m2 vs. 24.5 ± 3.5 kg/m2, p = 0.003) in the severe bowing group. The duration of bisphosphonate use was shorter in the severe bowing group than in the minimal to moderate bowing group (3.3 ± 3.8 years vs. 5.0 ± 4.0 years, p = 0.048). In the severe bowing group, 85% of AFFs were diaphyseal in contrast to the 46% in the minimal to moderate bowing group (p < 0.001). Cumulative percentage plot of AFFs in the severe bowing group was left-shifted compared to the minimal to moderate bowing group.

Conclusions: At the time of AFF diagnosis, the severe bowing group exhibited shorter duration of bisphosphonate use, lower BMI, and a higher incidence of diaphyseal location. Shortening the duration of bisphosphonate therapy may be advisable in patients with severe femoral bowing.

双膦酸盐相关非典型股骨骨折严重弯曲的影响。
背景:长期使用双膦酸盐是非典型股骨骨折(AFFs)的危险因素。已知股骨弓形与af有关。然而,股骨弯曲是否会加速AFF的发生尚不清楚。本研究的目的是确定严重股骨弯曲患者是否比没有严重股骨弯曲的患者更早发生AFF。方法:选取2006年1月至2022年12月的164例afs患者(186例)作为研究对象。根据股骨弯曲的严重程度将患者分为2组:重度弯曲组(26根股骨)和轻度至中度弯曲组(160根股骨)。比较两组患者的年龄、性别、AFF的完整性和部位。我们用两组间的累积百分比比较双膦酸盐治疗后AFF发生的时间。结果:两组患者年龄、性别相近,重度弯曲组体重指数(BMI)较低(22.5±3.0 kg/m2 vs. 24.5±3.5 kg/m2, p = 0.003)。重度弯曲组使用双膦酸盐的时间短于轻度至中度弯曲组(3.3±3.8年比5.0±4.0年,p = 0.048)。在严重弯曲组中,85%的af发生在骨干处,而在轻度至中度弯曲组中,这一比例为46% (p < 0.001)。与轻度至中度弯曲组相比,严重弯曲组af的累积百分比图左移。结论:在AFF诊断时,严重弓形组双膦酸盐使用时间较短,BMI较低,骨干定位发生率较高。缩短双膦酸盐治疗时间对于严重股骨弯曲患者是可取的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.50
自引率
4.00%
发文量
85
审稿时长
36 weeks
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