Osteoporosis and Hip Fracture: Reduce Your Risk

Osteoporosis and hip fracture are conditions that seem to go hand in hand.  Unfortunately, many of us know someone who has had a fall that resulted in a hip fracture. 

Later we find out that they also have a history of osteoporosis.  In order to understand how these two conditions correlate, it is important to understand osteoporosis.

The Basics of Osteoporosis

Osteoporosis can be described by low bone density.  Your bones have parts that are porous and resemble a honeycomb.  In people with osteoporosis, the spaces in the honeycomb are much bigger and there is less structural support in the honeycomb. 

This happens when you lose too much bone mass, make too little bone or both.  With low bone mineral density, your bones become weak and are prone to breaking. 

As a normal part of body function, our bones are constantly losing old bone material and creating new bone mass.  Unfortunately, as you age, you can lose more bone than you form, which leads to weak and brittle bones. 

The most common areas of osteoporosis related bone loss is in the wrists, spine and hips.  According to the National Osteoporosis Foundation, approximately 54 million Americans have low bone density or this condition. 

How Osteoporosis and Hip Fracture are Related

Because individuals with osteoporosis have low bone density and weak bones, they are more likely to break.  Broken bones related to osteoporosis are common at the hip.  As we age, we are more likely to break a hip, as the rate of falls increases with age. 

According to the Centers for Disease Control, one in every three adults age 65+ has a fall each year.  This means that 33% of older individuals are falling each year.  When you have low bone mineral density, then your bones are prone to breaking with even a small amount of stress.

Think about the force placed on your bone if you were to fall right on your hip.  You can imagine that the weight of your body would be enough to break the bone.  This why these two conditions go hand in hand. 

Prevention strategies

There are strategies you can use to decrease your likelihood of having osteoporosis and hip fracture.  In order to improve your bone mineral density, you should walk daily.  To reduce your risk of hip fracture, you should actively work on improving your balance and strength to reduce your risk of falls. 

Many older adults do not want to talk to their family or healthcare providers about falling, because they are afraid of how they might respond.  However, it is important to address the underlying causes that can result in falling to avoid future injuries. 

Set up your home for success and avoid environmental hazards that can cause you to fall at home.  One of the best ways to prevent a hip fracture related to osteoporosis is to stay up on your feet!

After a Hip Replacement: What to Do

After a hip replacement, there are several “rules” that you may have to follow, depending on the type of hip replacement surgery you underwent.  Dislocation and infection are the two most common complications after this type of procedure. 

Your physical therapist and medical team will explain to you the importance of avoiding specific movements to avoid dislocation.

Know the Dos’ and Don’ts

Precautions After a Hip Replacement

The posterior approach to hip replacement involves making an incision and replacing the joint through the side of the hip. 

This approach has three main movements that are restricted in order to reduce the likelihood of dislocation.  You should avoid crossing your legs, pointing your toes inward and avoid bending forward past a 90 degree angle. 

You cannot bring your knee up toward your chest. You may not bend forward as you traditionally would to reach something from the floor, or put on your shoes.  There are strategies to be successful with dressing and reaching without breaking your hip precautions.

The anterior approach is a more recent way of performing this surgery.  After an anterior approach, you must avoid excessive hip extension, which means that you cannot kick your leg backward behind your body.  Normal walking is okay, but any movement that stretches the leg behind your body is not allowed.

Equipment and Aids You Will Need

In order to ensure the safety of your hip, you will likely use a “hip kit” which will consist of tools that allow you to put on and take of your shoes and socks, as well as a long handled reacher.  The reacher allows you to grab things that you would otherwise have to bend forward to obtain. 

This prevents you from moving in a way that may risk dislocation.  You will also be using some type of walking device, such as a walker, crutches or a cane.  Walking devices keep you safe while relearning how to walk.

Hip Replacement Home Exercise

Exercise is a crucial component to your rehabilitation.  You underwent a major surgery and it is important that you do everything for optimal outcomes.  Home exercises are meant to restore range of motion and strength around your new joint. 

Your home exercises will consist of simple strengthening activities that can be done with little or no equipment.  Your therapist will instruct you on proper form and execution.  Be diligent about your home exercises and you will regain strength quickly.

Following Up

It is essential to have consistent medical supervision after a hip replacement.  You will be followed by your physical therapist and he or she will answer many questions that may arise. 

You will have regularly scheduled appointments with the surgeon and his surgical team to assess your progress and healing.  Your follow up care will ensure successful outcomes to get you back to where you want to be.