Periprosthetic Fracture of the Femur After Long-Term Bisphosphonate Use A Case Report Foster Chen, BS, and Timothy Bhattacharyya, MD Investigation performed at the National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland B isphosphonates are popular drugs that are used for the prevention of osteoporotic fractures. This class of medication suppresses bone turnover by inhibiting os- teoclast function and promoting osteoclast apoptosis, a bene- ficial process in attenuating bone resorption. However, there have been recent concerns that although bisphosphonates Fig. 1 Anteroposterior radiograph of the pelvis obtained three months prior to fracture. Cortical thickening and beaking is present near the distal tips of both prostheses (arrows). A horizontal fracture line near the tip of the left femoral prosthesis can be seen. Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, one or more of the authors has had another relationship, or has engaged in another activity, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article. 1 COPYRIGHT Ó 2012 BY THE J OURNAL OF BONE AND J OINT SURGERY,I NCORPORATED JBJS Case Connect 2012;2:e21 d http://dx.doi.org/10.2106/JBJS.CC.K.00085