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A 78-year-old woman presented with an atypical femoral fracture of her right femur associated with a left thigh stress fracture following 9 years of bisphosphonate therapy. The fracture was managed with femoral nailing. However, she represented 3 years later with peri-prosthetic infection, worsening of the left-side stress fracture, and low bone turnover in a bone metabolic study, consistent with an ongoing bisphosphonate effect. This case highlights the increased rate of postoperative complications in atypical femoral fractures even y
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