Differences in bone histomorphometry between White postmenopausal women with and without atypical femoral fracture after long-term bisphosphonate therapy
Authors' conclusion
In conclusion, in the ilium of BP-treated patients with osteoporosis, AFF patients have lower thickness of superficial bone (lower W.Th) of the cancellous and cortical envelopes than non-AFF patients. AFF and non-AFF patients have a similar bone turnover rate in the ilium. Furthermore, in this population, as in previous work, AFF is more likely to occur in BP-treated patients with longer treatment duration.
Study context
- Population
- White postmenopausal women treated for osteoporosis continuously with alendronate for 4–17 yr
- Participants
- 52 women
- Comparison
- Atypical femoral fracture (AFF) vs non-AFF patients after long-term alendronate
- AFFn = 20
- non-AFFn = 32reference
- Outcome
- Bone histomorphometric endpoints reflecting microstructure and turnover in cancellous, intracortical and endocortical envelopes of transilial biopsies
Methodological detailsage-, gender- and treatment time-matched, transiliac bone biopsies
- Age-, gender- and treatment time-matched
- Transiliac bone biopsies
Main finding
As reported in the abstract
Bone histomorphometry
- Cancellous and intracortical envelopes: significantly lower wall thickness (W.Th) in AFF vs non-AFF
- Cancellous and intracortical envelopes: significantly higher osteoclast surface (Oc.S/BS) in AFF vs non-AFF
- Intracortical envelope only: significantly higher eroded surface (ES/BS) in AFF
- None of the dynamic variables related to bone formation and turnover differed significantly between groups
Observational data: associations, not effects.
Further findings
Duration of alendronate treatment · longer with AFF
P = 0.014
Original publication
Differences in bone histomorphometry between White postmenopausal women with and without atypical femoral fracture after long-term bisphosphonate therapy. J Bone Miner Res. Published 5 February 2024. doi:10.
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