How common is osteonecrosis with bisphosphonates?

The prevalence in patients taking oral bisphosphonates is very low, ranging from 0.07 to 0.10 percent,2 although it is considerably higher in patients with cancer who are taking high-dose intravenous bisphosphonates. Osteonecrosis related to bisphosphonates occurs almost exclusively in the jaw.

What is the treatment for osteonecrosis of the hip?

If osteonecrosis has advanced to the point where the femoral head has already collapsed, the most successful treatment is total hip replacement. In this procedure, your doctor removes the damaged bone and cartilage, then positions new metal or plastic joint surfaces to restore the function of your hip.

What is the best treatment for osteonecrosis?

Arthroplasty/total joint replacement – Total joint replacement is the treatment of choice in late-stage osteonecrosis when the joint is destroyed. In this surgery, the diseased joint is replaced with artificial parts.

What are the side effects of bisphosphonates?

General side effects of bisphosphonates and denosumab

  • Fever and flu-like symptoms.
  • Low levels of calcium in your blood (hypocalcaemia)
  • Bone and joint pain.
  • Changes in bowel movements.
  • Tiredness and low energy levels.
  • Feeling sick.
  • Changes to your kidneys.
  • Irritation of the food pipe (oesophagus)

Why do bisphosphonates cause fractures?

Long-term bisphosphonate therapy can change bones at the microscopic level to make them more susceptible to the rare catastrophic transverse breaks known as atypical femoral fractures (AFFs), scientists said.

Can hip necrosis be cured?

Treatment can slow the progress of avascular necrosis, but there is no cure. Most people who have avascular necrosis eventually have surgery, including joint replacement. People who have avascular necrosis can also develop severe osteoarthritis.

Are bisphosphonates worth the risk?

How well do bisphosphonates prevent bone fractures? Bisphosphonates have been proven to reduce the risk of bone fractures. Their effectiveness depends on the woman’s bone density, age and other risk factors. The following illustration shows what women can expect from treatment with these medications.

Do bisphosphonates make bones more brittle?

Bisphosphonates Cause Brittle, Aged Bone With More Mineralization. The researchers first established that biopsies taken from patients who had developed an AFF showed evidence of elevated tissue mineralization.