Dr Mont's comment on elderly fractures

[John C]

I have been wondering about something that Dr Mont said during the podcast that Pat put together for everyone a month or so ago. He said that one of his concerns with resurfacing was the possibility of a femoral neck fracture years later when a person became elderly and vulnerable to falls.
Here is why that statement surprised me, and why I would like to hear Pat, Dr Mont, or anyone else chime in with their thoughts. Studies that I have read in the past usually confirm that the femoral bone around a THR grows weaker with time due to stress shielding. I have read numbers ranging around 80 to 90% of the pre-op bone strength once a person is out 5 years. On the other hand, the only bone density studies that I have seen showing post-op results on resurfacing show and average of 110% after a couple of years. This would seem to indicate that a person with a resurfacing, elderly or not, would be less vulnerable than the average person. Of course someone with a THR is not going to have a femoral neck fracture because that has been removed and replaced with metal, but I would expect that the weakened femoral bone around the prosthesis would be vulnerable, which is what I have seen with people I know who have taken a bad fall with THRs and ended up with femoral shaft or trochanteric fractures.
The one problem with a resurfacing could be if a person became inactive and largely non-weight bearing, in which case the femoral neck would weaken along with the rest of the persons bones, but I do not see a reason that this would be any worse than a person without a resurfacing. Perhaps Dr Mont has seen some problems that have not been published yet?
Any thoughts from anyone? Perhaps Pat could make a note to ask Dr Mont about this comment next time she talks to him?

[blinky]

Curious about this, too, especially as a post menopausal woman. I don't know that I personally would be losing bone, but my category of patient would be. (But this would be true for THR as well.)


Have also wondered about the effect of treatments for other conditions on the fixation of the prosthesis, like would someone who underwent chemo suffer aseptic loosening. I throw that out as another concern of those of us who hope to grow old with resurfs.