Periprosthetic and Peri-implant Fractures Medication

Updated: Apr 04, 2023
  • Author: Steven I Rabin, MD, FAAOS; Chief Editor: Murali Poduval, MBBS, MS, DNB  more...
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Medication Summary

Bisphosphonates, including alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), and zoledronate (Reclast) may help decrease the progression of osteoporosis. Adequate calcium and vitamin D intake is essential for bisphosphonates to be effective.  Long term use has been associated with atypcial femoral shaft insufficiency fractures.  Long term use is also associated with atypical proximal periprosthetic femur fractures. [18]

After menopause, estrogen therapy reduces bone loss, increases bone density in both the spine and hip, and reduces the risk of fractures. Estrogen therapy increases the risk of endometrial and possibly ovarian cancers so should be used with caution for short times only.


Selective Estrogen Receptor Modulators