Fractures More Likely After Hip Replacements

June 4, 2015 Updated: June 4, 2015
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The incidence of femoral fracture after hip replacement is only 0.25 percent without falling, but there is a 250 percent increased risk for fractures in 2.5 to 5 years after hip replacement surgery, compared to those who do not have hip disease. Falling off a bike after a hip replacement puts a person at extremely high risk for a femoral fracture. Breaking a bone around a hip joint replacement weakens the bone so much that it may never heal normally.

Hip replacement and knee replacement surgeries have become commonplace but I always encourage people to put them off as long as possible. I think that you should not get your hip replaced until the pain is so constant that you can’t sleep at night. Be sure that you understand the possible consequences of a replacement joint:

Once you have had joint replacement surgery, you should not run or jump.
  • If you get an infection anywhere in your body and the germ gets into your bloodstream, it can get into the hip replacement which has no local immunity and can be very difficult to treat.
  • If you fall, the bones surrounding the joint are weakened by the rods in them and you are at high risk for breaking that bone. Sometimes a broken femur in a hip replacement never heals properly.
  • Once you have had joint replacement surgery, you should not run, jump or do any type of high-impact exercise since the force of your foot hitting the ground can loosen the joint replacement.
(JEAN-PIERRE CLATOT/AFP/Getty Images)
(Jean-Pierre Clatot/AFP/Getty Images)

Why All People Should Exercise as They Age

Everyone loses muscle fibers with aging. The vastus medialis muscle in the front of your upper leg has 800,000 fibers in a 20 year old and only 200,000 fibers in a 60 year old. Aging weakens you no matter how much you exercise and increases your chances of falling. Your bones also become thinner and weaker with aging which increases your chances of breaking them. One in three people over 65 suffer major falls. More than 90 percent of broken hip bones occur in people over 60, and the United States has the highest rate of hip fractures in the world. Older women who break their hips are five times more likely to die within a year than women of the same age who don’t break a hip.

Exercise also sensitizes muscles to insulin, which lowers high blood sugar levels and helps to prevent diabetes. Since diabetes is the most common of the known causes of heart attacks, exercise along with a high-plant diet helps to prevent heart attacks.

My 5 Recommendations

  1. Everyone should exercise and it becomes more important to exercise as you age since aging weakens bones and muscles. Furthermore, the average North American gains five pounds per decade after age 20, and regular exercise helps you avoid weight gain. Obesity increases risk for diabetes, heart attacks and cancers, and exercise helps to prevent all of these problems.
  2. If your hips or knees hurt, work with your doctor to find a cause.
  3. Try to move that painful joint every day. Inactivity causes further damage.
  4. People with cartilaginous damage to their knees and hips and those with hip and knee joint replacements should never run, jump, or walk fast. The impact of your foot hitting the ground causes further damage. Pedaling is done in a smooth rotary motion that does not jar the hip or knee replacements; however, a fall could be disastrous so consider a stationary bicycle or tricycles which Diana and I use. Jogging in water or swimming are usually safe as the buoyancy of the water dampens impact and helps to prevent joint damage.
  5. Delay hip and knee replacement surgery until it hurts so much that you can’t sleep at night or you have some other compelling reason.

Gabe Mirkin, M.D., has been a practicing physician for over 50 years. He is board-certified in sports medicine, allergy and immunology, pediatrics, and pediatric immunology. This article was originally published on DrMirkin.com. Subscribe to his free weekly Fitness & Health newsletter.