I had total hip replacement (left, anterior) this past March at age 61 after going airborne off an icy step and landing on solid ice precisely on my side (nothing breaking my fall but my left hip--no elbows, feet, shoulders, etc. helped to break my fall). I broke my left femur neck right in two. I went straight to the ER and had surgery 2 days later.

I am fit and active and somewhat slight (5'7" and 135 lbs); I guess because of the momentum of my fall and it being from a step (?) it was not charted as a fragility fracture (although it turns out it should have been). I healed well and was back to normal with no pain at all within 7 weeks. I totally forget that I have an artificial hip/femur neck. My surgeon constantly says it's healed and adhered and settled "beautifully," but I wish I'd known I had OP when I'd met with him (!) (that information came later after I wouldn't take "don't worry about it" for an answer).

I had asked for a Dexa scan a couple of times in the previous 3 years but was told both times "not something we do till you're 65." (I now coach all of my friends to allude to their mother's OP, etc., to get their Dexas EARLY.) I had had 4 follow-ups with my ortho surgeon before there was any mention of getting a Dexa and it took another 6 weeks after that to get one. It came back
Spine -1.6
Right femur neck -2.2
Right total hip -2.6
I had repeatedly expressed concern about OP and it had kind of been pooh-poohed (!). Anyway, the surgeon handed me an rx for Fosamax and said he was required to do that because I had fallen, but to do my own research, which I did.

I handled my own PA and got myself Tymlos which I just got last week and have taken 3 doses of so far (3, 3, and last night 4 clicks). I'm trying to get orders for bone remodeling markers (CTX and PNP1) because I FINALLY got my PCP to refer me to an Endo.

Sorry this is jumbled. I wanted to pipe up that I'm interested in all that you've queried, too, and wanted to explain how/why I happened to be ignorant of having OP until WELL after my new hip was healed and forgotten (by me).