Q: I need to decide whether to have a hip replacement and want to know if it’s safe to ride after having the procedure. I am 60 years old, and not being able to ride my horse is not acceptable. Rather than give up my mare, I would continue with the throbbing pain and sleepless nights. What would you recommend I do? Name withheld by request

A: Thank you for asking this increasingly important question. You are not alone. The rider population in America is aging, so it follows that diseases of the aging process will become of greater concern to them. But I have good news: A hip replacement is no reason to give up riding, as long as you take appropriate precautions.

I presume that you will have a total joint replacement. This procedure replaces both the socket of the joint in the pelvis, called the acetabulum, and the “ball” on the head of the femur, or thighbone. The primary concern afterward is to avoid activities that could pull the prostheses away from the bony surface.

Make sure your surgeon knows you are a rider. If I could make a recommendation to him or her, it would be to use maximal adhesive techniques—that is, the best adhesives in abundant quantities—to secure the implanted prostheses to the bones.

Afterward, I would recommend these guidelines for you:

  • As you heal, keep your legs supported at all times so that the downward pull from the weight of your leg does not separate the replacement implants from the bone.
  • Never ride bareback or without stirrups in any way. This may produce traction on the implant and separation from the bone to which it is attached.
  • Always use a mounting block and don’t swing your leg too high.
  • Avoid posting until your surgeon gives you clearance to do so.
  • Dismount carefully, preferably onto a mounting block or another elevated surface, and never jump out of the stirrups onto the ground (which is sound advice for anyone).
  • If you are overweight, promise yourself that you will trim down. Every extra pound that you carry stresses your hips, whether they are your original ones or surgical implants.

In my experience, most people who have undergone hip replacements have had only one regret—that they did not do it sooner. And many of these patients have successfully returned to activities even more strenuous than riding.

James S. Warson, MD
Fairfax, Virginia