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Peer-reviewedCC BY-NC-NDBone Reports

Contralateral atypical femoral fracture following a single dose of denosumab after incomplete teriparatide therapy in a patient with long-term bisphosphonate exposure: A case report

  • Dong-Hoon Lee1
  1. 1Corresponding author.
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Abstract

Atypical femoral fractures (AFFs) are rare but serious complications of prolonged antiresorptive therapy. While bisphosphonate-associated AFF is well documented, the risk associated with sequential teriparatide and antiresorptive therapy remains poorly characterized. This case demonstrates that contralateral impending AFF can develop after a single dose of denosumab in a bisphosphonate-pretreated patient, despite confirmed radiological normality at the time of the index fracture. Negative contralateral imaging should not provide reassurance in high-risk patients, and vigilance is warranted when considering antiresorptive therapy transitions following incomplete anabolic treatment.

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Cite

BibTeXRIS
BibTeX
@article{lee2026contralateral,
  title = {{Contralateral atypical femoral fracture following a single dose of denosumab after incomplete teriparatide therapy in a patient with long-term bisphosphonate exposure: A case report}},
  author = {Dong-Hoon Lee},
  journal = {Bone Reports},
  year = {2026},
  month = oct,
  doi = {10.1016/j.bonr.2026.101965},
  url = {https://doi.org/10.1016/j.bonr.2026.101965},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Contralateral atypical femoral fracture following a single dose of denosumab after incomplete teriparatide therapy in a patient with long-term bisphosphonate exposure: A case report
AU  - Dong-Hoon Lee
PY  - 2026
DA  - 2026/10/24
JO  - Bone Reports
DO  - 10.1016/j.bonr.2026.101965
UR  - https://doi.org/10.1016/j.bonr.2026.101965
AB  - Atypical femoral fractures (AFFs) are rare but serious complications of prolonged antiresorptive therapy. While bisphosphonate-associated AFF is well documented, the risk associated with sequential teriparatide and antiresorptive therapy remains poorly characterized. This case demonstrates that contralateral impending AFF can develop after a single dose of denosumab in a bisphosphonate-pretreated patient, despite confirmed radiological normality at the time of the index fracture. Negative contralateral imaging should not provide reassurance in high-risk patients, and vigilance is warranted when considering antiresorptive therapy transitions following incomplete anabolic treatment.
SN  - 2352-1872
ER  -