When osteoporosis leads to a bone fracture, surgery is often necessary to treat the injury. Physical therapy, exercises, and calcium supplementation may also be helpful.
A diagnosis of osteoporosis means you have experienced a significant loss of bone density. This puts you at a much higher risk of a bone fracture.
The International Osteoporosis Foundation estimates that osteoporosis accounts for about 8.9 million broken bones worldwide every year, though the majority of people with the condition are never tested or treated for it.
If you experience a fracture caused by osteoporosis, surgery is often necessary. Other treatments include exercise and physical therapy to strengthen bones and muscles and reduce the risk of falls and future fractures. Supplementation with calcium and vitamin D may also help, though that’s a treatment that should be discussed with a healthcare team.
For severe osteoporosis fractures, surgery is usually the only way to effectively repair the affected bones or joints. Orthopedic surgery usually involves repositioning bone fragments and securing them in place with screws, plates, wires, or other implants.
Surgical repair allows the bone to heal and strengthen so it can resume movement and other functions, such as supporting weight.
The most common area requiring osteoporosis surgery is the spine, according to the American Academy of Orthopaedic Surgeons. Spinal fractures occur about twice as often as other fractures associated with osteoporosis. These include broken hips and bone fractures in the wrists and forearms.
Other fractures commonly associated with osteoporosis include fractures of the:
But any bone in the body can be affected by osteoporosis and be at greater risk of fracture.
There are two main types of osteoporosis-related hip fractures. Femoral neck fractures occur just below the femoral head, which is the “ball” in the hip’s ball-and-socket joint. Intertrochanteric fractures occur a little farther down the femur, between two bony protrusions called trochanters.
Women are about twice as likely as men to experience a hip fracture, according to the International Osteoporosis Foundation.
The three main kinds of hip surgeries include:
- Internal repair: Using screws, the orthopedic surgeon reattaches the parts of the femur separated by the fracture. If necessary, the screws may be attached to a small metal plate that runs down part of the femur for extra stability.
- Total hip replacement: In a total hip replacement, the upper femur, including the femoral head and the socket portion of the pelvis, are replaced by prosthetic parts.
- Partial hip replacement: When the socket portion of the joint doesn’t need to be replaced, a partial hip replacement may be a better option. In this procedure, the upper femur is still replaced by a prosthetic. The natural socket is instead resurfaced to work with the prosthetic femur.
Spinal fractures caused by osteoporosis are usually labeled as spinal compression fractures, and they almost always require surgery. The two most commonly used surgeries for spinal fractures are:
- Vertebroplasty: The surgeon injects a special kind of quick-drying cement directly into the damaged vertebra.
- Kyphoplasty: Also called “balloon kyphoplasty,” this procedure involves the insertion of a small balloon into the damaged vertebra to create space for cement to be applied.
The two main bones in the wrist are the radius and the ulna. Minor wrist fractures can often be treated without surgery by using a cast and immobilization.
Surgery to repair a fractured wrist often involves small pins to hold the broken bones in place. Plates and screws may also be necessary.
A second type of wrist surgery uses pins inserted through the skin and into the bones. The pins are attached to a device temporarily worn on the wrist that pulls the affected bones into place and keeps them there while they heal. This is called an external fixator.
One of the most important steps you can take before surgery is to make sure you have transportation home from the hospital and a family member or friend at home to help you for at least the first few days.
If you don’t have someone available and don’t have a home health aide or nurse to assist you, you may want to see about recovering in a short-term rehabilitation facility.
Before your surgery, you or a loved one should prepare the home to make things safer and more convenient for you. Move throw rugs and other tripping hazards. Have your phone, TV remote, and other items you’ll use on a bedside table or other easy-to-reach location.
Another important step includes getting guidance on medication use in the days and hours leading up to the surgery. This is especially true if you take blood thinners for a cardiovascular condition.
Joint replacement and other orthopedic surgeries can take a few hours. You’ll be under general anesthesia and will likely spend at least one night in the hospital.
For surgery such as a hip replacement, the surgeon removes damaged bone and cartilage and replaces them with prosthetic parts made of ceramic, metal, or plastic.
For other types of surgery, metal screws or other devices are used to reattach existing bone. Bone material that’s too badly damaged is removed and replaced with a plate or rod for stability.
After your surgery, you may be monitored overnight in the hospital for any signs of side effects. You’ll be discharged either to your home or to a rehabilitation facility for physical therapy.
Rehabilitation may include occupational therapy, too, depending on the bones treated with surgery.
As with any surgical procedure, there are potential risks and side effects associated with osteoporosis surgery. Among them are:
- bleeding
- infection
- pulmonary embolism (a blood clot that forms a vein and travels to the lungs)
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While surgical repair of osteoporosis-related fractures can restore function, relieve pain, and improve quality of life in many cases, the procedure isn’t a cure for osteoporosis. The risk of subsequent fractures is still high if you have osteoporosis.
The key to a positive outcome is to follow your surgery with consistent osteoporosis treatment, which may include medications, supplements, and changes to your diet and exercise regimens.
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Successful osteoporosis surgery also requires you to participate in your rehab and follow the healthcare team’s instructions when it comes to exercise and other lifestyle changes. A focus on balance training and fall prevention should also improve your short-term and long-term outcomes.
Do all osteoporosis-related fractures require surgery?
The decision to operate on a broken bone depends on the severity of the fracture and its location. Bones located within joints such as the hips or wrist often require surgery to make sure they can function and move properly within the joint. A minor fracture in the forearm, for example, may be treated by immobilizing the bone.
Is it always obvious when osteoporosis causes a fracture?
Osteoporosis is sometimes called a “silent disease” because it usually presents no symptoms until a fracture occurs. Even then, it’s not always obvious that you have a broken bone. Some people with back pain actually have a fractured vertebra, but they don’t know until they have their condition medically evaluated.
How do I prevent a fracture if I have osteoporosis?
Once a bone has lost a significant degree of tissue density, it’s not always possible to restore it to full strength. However, a balanced diet and weight bearing exercise can help. A doctor may also recommend medications, such as bisphosphonates, and supplementation with calcium and vitamin D to improve bone health and reduce your fracture risk.
When osteoporosis makes a bone more brittle and susceptible to fracture, surgery is often the only solution to properly treat the injury.
While fractures of the spine, wrists, and hips are the most common osteoporosis-related injuries, any bone can break when weakened by osteoporosis.
Surgery is just one treatment for bone fractures, and you and a healthcare team can discuss all of your options. Rest and time may help in some cases, while in others, surgery may be your only solution.
Be prepared to participate fully in your rehabilitation in order to regain your mobility and strength.
