Is that pain in my artificial hip caused by the weather?

A sporty reader, who likes to spend time in the mountains, wonders: “Is it true that titanium hips or plates on bone fractures can cause pain in bad weather or changes in the weather?”

You sometimes get an artificial hip if your hip is broken, but more often after wear and tear (arthrosis) of your own hip. The prosthesis that is placed is often made of titanium. This type of metal is light, very strong and not magnetic, so it does not cause any problems with MRI scans.

“In addition, titanium very rarely causes a reaction for the wearer and the prosthesis or implant therefore does not have to be removed,” says orthopedic surgeon Rachid Mahdad of the Alrijne hospital in Leiden. A cobalt-chromium alloy is more often used in knee prostheses. It also does not cause a reaction in people with a proven nickel allergy, which is noticeable when wearing jewelry.

According to Mahdad, there used to be hip prostheses that were completely made of metal on metal, or metal on polyethylene (plastic). Nowadays this is only partly the case. For example, the stem in the upper leg is made of titanium and so is the hip socket. The head of the stem is often made of ceramic and the inside of the bowl is made of polyethylene or ceramic.

Extra strength

In which cases do you get a titanium prosthesis for a broken hip? Mahdad: “With a lot of ifs and buts, you can roughly say that in patients under the age of sixty, the acetabulum is retained and a plate and a screw are used. In vital patients between the ages of 60 and 80, a prosthesis is usually fitted, and in patients over 80 who are dependent on care, a broken hip is fitted with a head and neck prosthesis or half hip prosthesis, with bone cement.”

In some cases, metal plates are also used for bone fractures in other parts of the body to give the fracture extra strength during healing. According to Mahdad, these plates are also usually made of titanium. He finds it an interesting question whether you notice this in bad weather. “As an orthopedic surgeon, I have been seeing patients with hip or knee prostheses for thirteen years and I must say that I hear it regularly in practice. People don’t really talk about pain, but say they do feel it. The patients who mentioned it say they feel the metal in cold weather, some in rainy weather. But it’s not like it bothers them.”

Metal conducts cold

Mahdad has never done any research into it himself and therefore looked into the medical literature, only to conclude that very little can be found about it. “I found a recent article from Saudi Arabia that examined the effect of cold weather on orthopedic implants. Half of the patient population studied indicated that they were bothered by the implant in cold weather. But that is difficult, because cold weather in Saudi Arabia does not have to be cold here.”

Mahdad says he cannot answer the question properly. However, he can imagine that if you are in the mountains, like the reader, and the weather is really icy, the metal can conduct the cold. “This will be less the case with deeper implants such as a hip. But implants that are closer to the skin surface, such as on a collarbone or ankle, can cool down more quickly. But it cannot be said with certainty whether this is the implant or scar tissue from the operation.”