What a hip replacement taught me about bone health and vasculitis
There are steps we can take to mitigate the damage to our bones
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By the time this column is published, I’ll be a couple of weeks into recovering from a hip replacement. I am writing it in advance because I’m fairly certain I won’t have the wherewithal to write coherently after the surgery.
I never imagined I’d need a hip replacement at this age — yet here I am, facing a surgery far more common in people 20 years older than I am. It’s one of those moments when living with ANCA vasculitis makes me feel older than my actual age. The wear and tear, numerous medications, and constant vigilance can age the body in ways the calendar doesn’t show.
But I thought a column about hip issues would be worthwhile, since many of us with vasculitis worry about how our meds may affect our bones. In the private patient Facebook groups I am part of, discussions about bone health and hip issues are common.
Joint pain is common in ANCA vasculitis, but the need for a hip replacement is usually driven by something else: the long-term impact of steroids, inflammation, or avascular necrosis (AVN). Chronic prednisone use — especially at moderate to high doses — can weaken bones over time, reduce bone mineral density, and increase the risk of fractures and AVN. Even after tapering, the effects can linger.
I’m not saying we shouldn’t take the medications that keep us alive. We should! But I do think that bone health should be part of our ongoing vasculitis management.
Bone health: What we can actually do
Most of us with ANCA vasculitis have likely taken steroids at some point. I hope your doctor discussed the potential side effects and any supplements that might benefit you. Supplements don’t fix the problem, but they may help slow the damage.
For patients taking steroids long term, doctors may recommend the following to promote bone health:
- Vitamin D and calcium supplementation (ideally after blood work confirms levels)
- Weight-bearing exercises, when possible and safe
- Bone density, or DEXA, scans to monitor changes over time
- Lifestyle support, such as increasing protein intake, reducing alcohol, and not smoking
- Prescription medications if osteopenia or osteoporosis is identified
These steps don’t eliminate risk, but they help us control what we can. They also make orthopedic surgeons incredibly happy, because stronger bones support better recovery.
Getting older at a younger age
This part feels important to say out loud: Needing a surgery like a hip replacement “before your time” can feel unfair and isolating. For me, it was another period of moving from disbelief to acceptance — and finally looking forward to the pain relief.
Vasculitis changes how we move through the world and forces us to make difficult decisions. But it also teaches us presence. It reminds us to listen to our bodies in a way many people don’t learn until much later. And it gives us a chance to rebuild, literally and figuratively, for the life that still lies ahead.
Note: ANCA Vasculitis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of ANCA Vasculitis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to ANCA vasculitis.
Patti
My hip replacement was done after years of osteopenia medications. I had taken steroids for ANCA Vasculitis and had 5 years of infusions. My hip replacement was done anteriorly. I selected the doctor based on 2 interviews and a couple of client testimonials. The procedure went well. I took the prescribed meds but never required pain medications. I followed instructions and did home therapy and exercises. I was fearful of falling and should have moved and walked outside more often. Best wishes with your procedure and recovery.
Sheila Wilbur
WOW! Your article really "jumped" out at me! I am exactly two weeks post-op today after having had a total knee replacement. When my ANCA vasculitis was diagnosed four yrs. ago I was treated with liberal doses of steroids. Might this have contributed to my joint deteriosis? Also, while speaking with healthcare professionals, several have asked me "what is ANCA vasculitis?" I really wish more health care professionals were familiar with this condition.
Carol Burnett
Since diagnosis I’m tired all the time, each day is a push. I was told I need a hip replacement, but I’m not ready for that, so I’ve decided to participate in a program at my local physio place. I’m hoping to get a few more years before surgery is necessary. Is exhaustion common?