Hip replacements for fractured hip due to osteoporosis

Hello! The short version of what I wrote is that I (62/F) had a fall on ice 9 months ago that took me to the OR and then on to emergency hip replacement surgery since my left femoral neck was broken right in 2.

I'd asked for DEXA's before a few times, but had always been told "not till you're 65." OP wasn't really discussed much while I was inpatient for surgery or in the first few follow-up months (perhaps because the way I fell wasn't clearly a fragility fracture?). But I did finally get orders for a DEXA as the surgeon released me at 4 months or so and it turned out my OTHER (right) total hip had a T-score of -2.6. (Right femoral neck was -2.1 and spine was -1.8.)

Anyway, I started my journey to push back on this surprise osteoporosis by starting meds last month (Tymlos). I got the meds as a result of my own research and advocacy to my fairly indifferent PCP and I have my first-ever appointment with an endocrinologist in 2 days to see if he agrees with the course I selected for myself.

But, true confessions, my Total Hip Replacement (anterior) THR-a went SOOOO smoothly that I've actually flirted with the idea of doing some medical tourism and going and getting my other hip done voluntarily/self-pay just to rid my body of osteoporosis and free myself of the complicated medication journey I just started... (I was walking barely holding on to a walker a day after surgery and I only used my walker for about 5 days after getting home. I honestly forget that I've had the surgery at all and that started at about 2 months post-op. I think it may have gone so smoothly for me because I was very active before my accident, had never had hip pain, and all of my supporting muscles, etc., were in recent use and good shape.) I know that in reality getting elective self-pay THR surgery is a frivolous idea, but it's definitely tempting when I'm daydreaming and I think I'd do it if I had near certain chances of it going so smoothly a second time! 🙂

I pressed my surgeon on whether my broken left hip was osteoporotic and he was vague and said "well it wasn't falling apart in my hands or anything--I've definitely seen way worse." He said the surgery went extremely smoothly and I know everything has adhered (blessedly) well, so THR definitely CAN go well.

I had osteoporosis in both hips and spine. Last year, while on a year long treatment of Evenity, I had my right hip replaced. I asked the surgeon about this - what if hip too mushy for hip replacement? He said that he could manage that.
The hip replacement has been very successful. So was the 12 months of Evenity. I had no side effects from the drug other than a day of flu like symptoms for one day. That was only after the first month of injections.

Thanks for your reply, @susanfalcon52, that is great news for the collective OP community and it’s good to hear from someone who has experienced both OP and a hip replacement.

I’ve also wondered about spinal surgery, in the event of collapsed vertebrae, to keep us upright - my brother had rods placed in his back 30+ years ago after a devastating accident. Those rods are what has kept him moving around after all these years. One thing I notice when visiting medical facilities is the number of “older” women . . . and men . . . who don’t seem to be walking particularly upright and it frightens me.

I, too, had a year long treatment of Evenity with a great outcome and no side effects.

The best to you! Cheers!

That's great that your hip replacement was such a success. It heartening to hear of your successful year on Evenity, too.

Of course it's not true of all of them, but it seems like a high percentage of ortho surgeons are pretty vague/fuzzy about their patients' bone density and osteoporosis issues and they don't want to be asked too many questions. (My surgeon wanted to follow up with me frequently in the first few months after my surgery, but he never really talked to me about OP or drug therapy or getting a DEXA until our final meeting and then he gave me a little brochure and an rx for Fosamax, muttering something about "CMM rules say I have to educate you about OP since it was a fall that brought you to me, so here you go, but (paraphrasing now) please don't ask me any further questions about it and just follow up with your PCP or an endo."

A number of people on here have talked about being surprised that their orthopedic surgeon couldn't or wouldn't tell them more about OP, so it must be a bit of a "thing" that they don't delve too far in to it.

Can you share your before and after Evenity DEXA scores? Thank you.

Can you share your before and after Evenity DEXA scores? Thanks.

From 2022/2024, my dual femur scores improved from -2.5 to -2.1 and my lumbar spine from -2.9 to -1.0. Note that the most recent scores were done on a different machine than the 2022 scans, but I use the -1.0 spine as a current and true value.

My rheumatologist also mentioned something about the lumbar score perhaps being positively affected by three compression fractures as the bone is “reinforced” during the healing process. It doesn’t matter to me the how or why, just that it is. Who knew?

Finally, I’m unsure if Tymlos or Evenity worked for me in providing the better scores - I used Tymlos for about 9-1/2 months, and Evenity for the full 12 months. I’ve chronicled my severe and debilitating reactions to Tymlos and the ease of Evenity previously.

Wishing everyone a safe and joyful holiday season. Tread carefully and mind the slippery conditions Old Man Winter brings with him. Cheers, all!

Thank you for bringing this topic of hip replacement up! I've been wondering why replacement has never been discussed as I've gone through the journey of discovery of how severe my OP is, research, and then finally deciding to start Forteo last month. My doctors always tried the scare tactic of how I would be forever incapacitated if I broke my hip, etc. but no mention of surgery. I'm so glad to see how well replacement worked for you annie208!

I can't have surgery on my hip because my a1c is not low enough yet. diabetes 2

I am having severe pain before hip replacement anyone else