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Printable Handouts
Navigable Slide Index
- Introduction
- Disclosures
- Objectives
- Pharmacological therapy (1)
- Drug reduction of mortality
- Considerations with osteoporosis medications
- Importance of looking at the whole picture
- AFF definition
- Atypical femoral fractures (AFF)
- Hip fractures
- ASBMR recommendations
- AFF: ASBMR case definition 2010
- AFF: ASBMR case definition 2014
- Radiographic images of AFFs (1)
- 2014 ASBMR definition for incomplete AFF
- Femur X-rays
- Imaging using other modalities
- SE-femur
- Epidemiology
- Incidence of complete AFFs
- AFF–like in non-treated low-turnover osteoporosis
- Bisphosphonate, subtrochanteric fragility fractures
- Clinical risk factors
- Risk factors for AFFs
- Pathogenetic mechanisms
- Pathogenetic mechanisms: example
- AFF: key clinical feature
- Diagnosis and management
- Radiographic images of AFFs (2)
- Complete atypical femoral fractures
- Incomplete fracture case
- My recommendations for symptomatic patients
- Current ASBMR task force recommendations
- Example - healing of a fracture
- Teriparatide & fracture healing
- TAFF trial ongoing
- AFF
- Prevention - rethinking osteoporosis paradigm
- Bone is a complex structure
- Bone mineralization in bone remodeling
- How do I assess 10-year fracture risk?
- Pharmacological therapy (2)
- Because of AFF +/- ONJ…
- Summary
- Thank you
Topics Covered
- AFF definition and key clinical features
- Pharmacological therapy and considerations
- Imaging: x-rays and other modalities
- Epidemiology
- Risk factors
- Diagnosis, management and recommendations
- Incomplete AFF
- Fracture healing
- Prevention: rethinking osteoporosis paradigm
- Assessment of fracture risk
Talk Citation
Cheung, A. (2016, October 31). Atypical femoral fractures [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 8, 2024, from https://doi.org/10.69645/VRWO2777.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Angela Cheung has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Other Talks in the Series: Bone in Health and Disease
Transcript
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0:00
I'm Angela Cheung
from Toronto, Canada,
and I am going to discuss
Atypical Femoral Fractures today.
0:09
These are my disclosures.
I have received honoraria from,
for CME events and/or grants
to my institution from these companies.
And I've also been a member of
the ASBMR International Task Force
on Atypical Femoral Fractures,
as well as the Osteoporosis
Canada Guidelines
on the Diagnosis, Management,
and Prevention of
Atypical Femoral Fractures.
0:37
I'm going to discuss
the definition, epidemiology,
clinical risk factors,
diagnosis and management,
and prevention
of atypical femoral fractures.
0:49
Right now in osteoporosis,
these are the pharmacological therapies,
they are in Canada.
The first line therapies are
antiresorptive therapies
with bisphosphonates,
denosumab, raloxifene,
and estrogen in menopausal women
with symptoms
as well as bone formation therapy,
and we only have one,
it's called teriparatide.
These therapies have been shown
to reduce vertebral fracture,
hip fractures,
and non-vertebral fractures
as you can see on the slide
based on randomized control trials.
1:30
They've also been shown,
especially the antiresorptive therapies
with bisphosphonates and denosumab
in a meta-analysis done by Bolland,
they have been shown to reduce
mortality as well.
The relative risk here of 0.89
is statistically significant.