{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T15:30:26Z","timestamp":1792251026328,"version":"4.4.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T00:00:00Z","timestamp":1619654400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T00:00:00Z","timestamp":1619654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Osteoporos Int"],"published-print":{"date-parts":[[2021,10]]},"DOI":"10.1007\/s00198-021-05948-w","type":"journal-article","created":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T08:02:59Z","timestamp":1619683379000},"page":"2119-2123","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Progression of atypical femur stress fracture after discontinuation of bisphosphonate therapy"],"prefix":"10.1007","volume":"32","author":[{"given":"K.D.","family":"Gu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Ettinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.D.","family":"Grimsrud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7159-0648","authenticated-orcid":false,"given":"J.C.","family":"Lo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,29]]},"reference":[{"issue":"3","key":"5948_CR1","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1302\/0301-620X.89B3.18146","volume":"89","author":"SK Goh","year":"2007","unstructured":"Goh SK, Yang KY, Koh JS et al (2007) Subtrochanteric insufficiency fractures in patients on alendronate therapy: a caution. J Bone Joint Surg (Br) 89(3):349\u2013353","journal-title":"J Bone Joint Surg (Br)"},{"issue":"3","key":"5948_CR2","doi-asserted-by":"publisher","first-page":"1294","DOI":"10.1210\/jc.2004-0952","volume":"90","author":"CV Odvina","year":"2005","unstructured":"Odvina CV, Zerwekh JE, Rao DS, Maalouf N, Gottschalk FA, Pak CY (2005) Severely suppressed bone turnover: a potential complication of alendronate therapy. J Clin Endocrinol Metab 90(3):1294\u20131301","journal-title":"J Clin Endocrinol Metab"},{"issue":"12","key":"5948_CR3","doi-asserted-by":"publisher","first-page":"2544","DOI":"10.1002\/jbmr.1719","volume":"27","author":"RM Dell","year":"2012","unstructured":"Dell RM, Adams AL, Greene DF, Funahashi TT, Silverman SL, Eisemon EO, Zhou H, Burchette RJ, Ott SM (2012) Incidence of atypical nontraumatic diaphyseal fractures of the femur. J Bone Miner Res 27(12):2544\u20132550","journal-title":"J Bone Miner Res"},{"issue":"12","key":"5948_CR4","doi-asserted-by":"publisher","first-page":"2515","DOI":"10.1007\/s00198-019-05112-5","volume":"30","author":"JC Lo","year":"2019","unstructured":"Lo JC, Grimsrud CD, Ott SM, Chandra M, Hui RL, Ettinger B (2019) Atypical femur fracture incidence in women increases with duration of bisphosphonate exposure. Osteoporos Int 30(12):2515\u20132520","journal-title":"Osteoporos Int"},{"issue":"1","key":"5948_CR5","doi-asserted-by":"publisher","first-page":"100","DOI":"10.3109\/17453674.2015.1004149","volume":"86","author":"J Schilcher","year":"2015","unstructured":"Schilcher J, Koeppen V, Aspenberg P, Michaelsson K (2015) Risk of atypical femoral fracture during and after bisphosphonate use. Acta Orthop 86(1):100\u2013107","journal-title":"Acta Orthop"},{"issue":"8","key":"5948_CR6","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1056\/NEJMoa1916525","volume":"383","author":"DM Black","year":"2020","unstructured":"Black DM, Geiger EJ, Eastell R, Vittinghoff E, Li BH, Ryan DS, Dell RM, Adams AL (2020) Atypical femur fracture risk versus fragility fracture prevention with bisphosphonates. N Engl J Med 383(8):743\u2013753","journal-title":"N Engl J Med"},{"issue":"1","key":"5948_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/jbmr.1998","volume":"29","author":"E Shane","year":"2014","unstructured":"Shane E, Burr D, Abrahamsen B, Adler RA, Brown TD, Cheung AM, Cosman F, Curtis JR, Dell R, Dempster DW, Ebeling PR, Einhorn TA, Genant HK, Geusens P, Klaushofer K, Lane JM, McKiernan F, McKinney R, Ng A, Nieves J, O'Keefe R, Papapoulos S, Howe TS, van der Meulen MCH, Weinstein RS, Whyte MP (2014) Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 29(1):1\u201323","journal-title":"J Bone Miner Res"},{"issue":"33","key":"5948_CR8","doi-asserted-by":"publisher","first-page":"8722","DOI":"10.1073\/pnas.1704460114","volume":"114","author":"AA Lloyd","year":"2017","unstructured":"Lloyd AA, Gludovatz B, Riedel C, Luengo EA, Saiyed R, Marty E, Lorich DG, Lane JM, Ritchie RO, Busse B, Donnelly E (2017) Atypical fracture with long-term bisphosphonate therapy is associated with altered cortical composition and reduced fracture resistance. Proc Natl Acad Sci U S A 114(33):8722\u20138727","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"7","key":"5948_CR9","doi-asserted-by":"publisher","first-page":"2173","DOI":"10.1148\/rg.2018180073","volume":"38","author":"RA Marshall","year":"2018","unstructured":"Marshall RA, Mandell JC, Weaver MJ, Ferrone M, Sodickson A, Khurana B (2018) Imaging features and management of stress, atypical, and pathologic fractures. Radiographics. 38(7):2173\u20132192","journal-title":"Radiographics."},{"issue":"1","key":"5948_CR10","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.bone.2012.02.632","volume":"51","author":"JC Lo","year":"2012","unstructured":"Lo JC, Huang SY, Lee GA, Khandewal S, Provus J, Ettinger B, Gonzalez JR, Hui RL, Grimsrud CD (2012) Clinical correlates of atypical femoral fracture. Bone. 51(1):181\u2013184","journal-title":"Bone."},{"issue":"6","key":"5948_CR11","doi-asserted-by":"publisher","first-page":"1755","DOI":"10.1007\/s00198-015-3063-8","volume":"26","author":"AJ Lovy","year":"2015","unstructured":"Lovy AJ, Koehler SM, Keswani A, Joseph D, Hasija R, Ghillani R (2015) Atypical femur fracture during bisphosphonate drug holiday: a case series. Osteoporos Int 26(6):1755\u20131758","journal-title":"Osteoporos Int"},{"issue":"12","key":"5948_CR12","doi-asserted-by":"publisher","first-page":"2417","DOI":"10.1007\/s00198-019-05067-7","volume":"30","author":"MA Png","year":"2019","unstructured":"Png MA, Mohan PC, Koh JSB, Howe CY, Howe TS (2019) Natural history of incomplete atypical femoral fractures in patients after a prolonged and variable course of bisphosphonate therapy-a long-term radiological follow-up. Osteoporos Int 30(12):2417\u20132428","journal-title":"Osteoporos Int"},{"issue":"2","key":"5948_CR13","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.bone.2013.02.004","volume":"55","author":"B Ettinger","year":"2013","unstructured":"Ettinger B, Burr DB, Ritchie RO (2013) Proposed pathogenesis for atypical femoral fractures: lessons from material research. Bone. 55(2):495\u2013500","journal-title":"Bone."},{"issue":"1","key":"5948_CR14","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1016\/j.bone.2012.10.006","volume":"52","author":"CY Chiang","year":"2013","unstructured":"Chiang CY, Zebaze RM, Ghasem-Zadeh A, Iuliano-Burns S, Hardidge A, Seeman E (2013) Teriparatide improves bone quality and healing of atypical femoral fractures associated with bisphosphonate therapy. Bone. 52(1):360\u2013365","journal-title":"Bone."},{"issue":"2","key":"5948_CR15","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1007\/s00198-017-4286-7","volume":"29","author":"SL Greenspan","year":"2018","unstructured":"Greenspan SL, Vujevich K, Britton C, Herradura A, Gruen G, Tarkin I, Siska P, Hamlin B, Perera S (2018) Teriparatide for treatment of patients with bisphosphonate-associated atypical fracture of the femur. Osteoporos Int 29(2):501\u2013506","journal-title":"Osteoporos Int"},{"issue":"11","key":"5948_CR16","doi-asserted-by":"publisher","first-page":"2349","DOI":"10.1007\/s00198-019-05131-2","volume":"30","author":"HY Zhang","year":"2019","unstructured":"Zhang HY, Weng HL, Li M, Zhang J (2019) Different surgical outcomes in a patient with bilateral atypical femoral fracture related to bisphosphonate use with or without teriparatide treatment. Osteoporos Int 30(11):2349\u20132354","journal-title":"Osteoporos Int"},{"issue":"5","key":"5948_CR17","doi-asserted-by":"publisher","first-page":"1682","DOI":"10.1210\/clinem\/dgz295","volume":"105","author":"DM van de Laarschot","year":"2020","unstructured":"van de Laarschot DM, McKenna MJ, Abrahamsen B et al (2020) Medical management of patients after atypical femur fractures: a systematic review and recommendations from the European Calcified Tissue Society. J Clin Endocrinol Metab 105(5):1682\u20131699","journal-title":"J Clin Endocrinol Metab"},{"key":"5948_CR18","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.bone.2016.01.002","volume":"85","author":"JC Lo","year":"2016","unstructured":"Lo JC, Hui RL, Grimsrud CD, Chandra M, Neugebauer RS, Gonzalez JR, Budayr A, Lau G, Ettinger B (2016) The association of race\/ethnicity and risk of atypical femur fracture among older women receiving oral bisphosphonate therapy. Bone. 85:142\u2013147","journal-title":"Bone."},{"key":"5948_CR19","doi-asserted-by":"publisher","first-page":"115319","DOI":"10.1016\/j.bone.2020.115319","volume":"135","author":"HH Nguyen","year":"2020","unstructured":"Nguyen HH, Lakhani A, Shore-Lorenti C, Zebaze R, Vincent AJ, Milat F, Ebeling PR (2020) Asian ethnicity is associated with atypical femur fractures in an Australian population study. Bone. 135:115319","journal-title":"Bone."},{"issue":"9","key":"5948_CR20","doi-asserted-by":"publisher","first-page":"2313","DOI":"10.1007\/s00198-014-2750-1","volume":"25","author":"JC Lo","year":"2014","unstructured":"Lo JC, Zheng P, Grimsrud CD, Chandra M, Ettinger B, Budayr A, Lau G, Baur MM, Hui RL, Neugebauer R (2014) Racial\/ethnic differences in hip and diaphyseal femur fractures. Osteoporos Int 25(9):2313\u20132318","journal-title":"Osteoporos Int"}],"container-title":["Osteoporosis International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00198-021-05948-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00198-021-05948-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00198-021-05948-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T04:01:23Z","timestamp":1634097683000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00198-021-05948-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,29]]},"references-count":20,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["5948"],"URL":"https:\/\/doi.org\/10.1007\/s00198-021-05948-w","relation":{},"ISSN":["0937-941X","1433-2965"],"issn-type":[{"value":"0937-941X","type":"print"},{"value":"1433-2965","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,29]]},"assertion":[{"value":"19 December 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study underwent an institutional review process and was deemed not to meet the regulatory definition of research. Patient consent for preparation and publication of this case study was obtained.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and informed consent"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}