Osteoporosis International

, Volume 27, Issue 2, pp 827–832 | Cite as

Simultaneous bilateral atypical femoral fracture in a patient receiving denosumab: case report and literature review

  • J. Selga
  • J. H. NuñezEmail author
  • J. Minguell
  • M. Lalanza
  • M. Garrido
Case Report


Osteoporosis remains a chronic and common disease associated with high medical costs. Pharmacological therapy has shown to be a good strategy to significantly reduce fracture risk. While literary evidence for bone protection in the short and medium term is strongly in it’s favor, there are concerns about long-term treatment with antiresorptive drugs. Increased risk of atypical femoral fractures (AFFs) have been demonstrated in several studies following the long-term use of bisphosphonate. Denosumab offers an alternative approach to the treatment of osteoporosis, however, it is also an antiresorptive drug. We present a case of simultaneous bilateral atypical femoral fractures in a patient with denosumab treatment. These findings highlight the need to reevaluate the optimal antiresorptive therapy duration, as well as the safety of transition from bisphosphonates to denosumab and the need for continued monitoring in the prevention of AFFs.


Atypical femoral fractures Bisphosphonates Denosumab Osteoporosis 


Compliance with ethical standards

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2015

Authors and Affiliations

  • J. Selga
    • 1
  • J. H. Nuñez
    • 1
    Email author
  • J. Minguell
    • 1
  • M. Lalanza
    • 1
  • M. Garrido
    • 1
  1. 1.Department of Orthopaedic Surgery of Vall d’Hebron HospitalPaseo de la Vall d’HebronBarcelonaSpain

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