As an orthopedic surgeon who treats all manner of injuries to the extremities, such as the shoulder, hip, and knee; the impact of osteoporosis on my patients is a major concern of mine. The treatment of osteoporosis has been greatly improved with the development of a class of medications called bisphosphonates. This treatment has resulted in a decrease in the rate of the typical hip fractures and other sequela of osteoporosis.
Unfortunately, there has been a growing awareness of an increased incidence of relatively atypical femoral stress fractures in those patients who have been on bisphosphonates for a long time. These atypical femoral fractures are harder to treat and slower to heal than the more typical type of hip fractures.
Recently, I have treated three individuals with atypical femoral stress fractures who had been on long-term bisphosphonate therapy. All of them reported experiencing hip/thigh pain for weeks prior to the stress fracture completing itself. This experience has shown me that the awareness of this problem has to increase. To that end, followers of my Facebook page (facebook/Robert-Purchase-MD) have seen the recent posts, including the recently made Youtube video (http://youtu.be/I4KioZS9fAQ).
Patients who have been taking these medications need to be more aware of this association, and doctors, myself included, need to consider this as an explanation of hip/thigh pain. It is suggested that a holiday from the medication can prevent the development of the problem all together, and appropriate treatment of the stress fracture can prevent the painful, acute event of fracture completion.
– Robert J. Purchase, MD
