Knee Fractures

[Brightside2]

I have recently had fragility fractures in both knees. I had been having Denosumab injections but they were stopped in January. Has this happened to anyone else?

[Met00]

Oh dear, so sorry to hear that. Did you relay onto a bisphosphonate (eg Alendronic Acid) when you stopped the Denosumab injections? There is clearly worded advice (what some call a Black Box Warning) that this is necessary as soon as the Denosumab injection is due, in order to minimise the risk of rebound fractures, which can occur within weeks of stopping, the risk lasting for up to 2 years. The issue is usually with rebound spinal fractures, but I don't see why other bones wouldn't also be affected.

[Brightside2 in reply to Met00]

Thank you for your reply. My Denosumab was stopped as I had gone from osteoporotic to osteopenic. I was not put on other Biphosphonates. I think the feeling was it does not usually occur in the knees and I had done a lot of walking.. I was given IV Zolendronic Acid so i am hoping that will help.

[Nannie-C in reply to Brightside2]

sad your Dr did not warn you before starting Prolia of the need to relay onto a bisphosphonate to try and stop the rebound phenomenon that occurs when anyone stop, belays or misses it. Rebound causes the density to plummet rapidly to pre or even lower levels and carries the real risk of multiple vertebral and other fractures occing during the at least two years of rebound.

At least he has now given you a relay drug albeit a bit late. Ensure he checks your bone turnover marker bloods to monitor your rebound.