Hip Replacement at a Young Age: What To Expect & Recovery Tips

I had a total hip replacement at age 40. Yeahhh it’s crazy. Though, I’m guessing that if you’re taking the time to read this post, you may be in a similar boat.

In fact, I had a super complex labral repair and hip arthroscopy to reshape the joint in my late 20s, to AVOID having a hip replacement at 35 (and I’d do it over again, it improved my quality of life immensely). I’d hoped to make it to 50. Turns out that was a pipe dream, but the great news is that the fake hip materials and the surgery method have improved so much since then that having one now isn’t a concern—it should easily last 25-30 years.

Why do it now?? I wasn’t in horrible pain…YET. In fact, it took me a while to realize that my hip was causing me issues again, because I was dealing with inflammation pain in my joints and muscles all over…but once I did realize it and got an MRI to confirm, it made total sense to get it done right away (also because I’d just been laid off so there were insurance considerations). Why wait? There really wasn’t an upside.

So in this post I’m taking a left-turn from my usual foodie content to talk about having a hip replacement at a young age, what to expect, and some recovery tips. I did a ton of searching before my surgery and couldn’t really find good info from people who had actually had it done, so wanted to share my experience. Buckle up, this post is LONG, but hopefully parts of it are super helpful in your own surgery journey.

It’s important to remember that EVERYONE IS DIFFERENT. And every surgeon’s protocol and approach might be different, so none of this is medical advice and you should definitely follow your doctor first! This is just sharing my experience and some things that worked for me.

A heads up on hip surgery at a young age

My early recovery was rougher than I’d expected…I had a subconscious expectation that this surgery recovery wouldn’t be that bad, because these are really straightforward surgeries and old people get it done all the time—heck, my dad had both his hips done, just 5 weeks apart! After going through mine, I…can’t even imagine.

I’ve had a number of different surgeries (many unrelated), and have a very high pain tolerance, so figured this one wouldn’t be that intense. But WOW, was I wrong?! I feel like I struggled with pain and discomfort more on this surgery than the others I had in the past 5 years, and after discussing with my surgeon’s office I have a slightly better understanding of why.

What they didn’t tell me but would have been helpful to know is, younger patients often have more pain and a more challenging early recovery from hip replacement than old people. Old people will have had more nerve deterioration, have much less muscle mass and soft tissue, etc., whereas young patients are often a lot more active and have a ton more music, soft tissue, and nerves that are (temporarily) traumatized in the surgery.

For me, my hip replacement was a little more complex as well, as they were fixing structural dysfunction and some other issues I had. (For context, I had previously had a mixed FAI impingement, labral tears, and mild dysplasia and early arthritis that was deteriorating further.) One of the things we hadn’t discussed ahead of time but I was fascinated by was that, previously, my right foot and hip joint faced outward quite a bit—always had. Now it faces straight ahead like my left foot/hip. So there was a ton of nerve, muscle, tendon, etc. reconnecting and realignment happening as I was healing from my surgery, and I think that’s why my nerve pain was so bad.

Preparing for your hip replacement surgery

I had surgery with Dr. Jonathan Yerasimides, who is well-known in my area, and specializes in the anterior approach. Your surgeon’s approach an important consideration…the anterior approach (where they go in through the front of the hip, vs. through the butt/back of the hip) is minimally invasive and so has better healing times.

My incision is around 8-9 inches long, and is horizontal(-ish, angled somewhat along the line of my thigh crease. My dad found this odd, he had both his hips replaced anterior, but his incisions were vertical. I asked a lot of questions around the fake hip joint materials, given my autoimmune issues…my body really does not like scar tissue or anything foreign. Mine was made of titanium, a bit of ceramic, and a tiny bit of silicone mimicking the labrum.

I had to get a CBC panel and EKG done beforehand. They gave me a super detailed book with instructions for before, during, and after the surgery, and also put me on this super helpful automated text program that would text me every day with tips (LOL or encouragement). Some of the things I had to do before the surgery included rubbing some antibacterial ointment in my nose for a few days before, stopping supplements and NSAIDS two weeks before, and using antibacterial soap in the shower a few days before.

They also had a few exercises they recommended leading up to surgery, but I didn’t bother with these as they felt like something for old patients who aren’t super active or strong. Instead, I walked 20,000+ steps a day for a few days beforehand on a last-second trip to Washington D.C.

And then there’s preparing your house and your life for a major surgery. Think about stocking up on groceries, including things that are easy to snack on and prep, particularly healthy, whole foods—lean protein, fruits and veggies, some complex carbs. It’s nice to have some food prepped in the fridge for the first day or two.

You DEFINITELY need to have someone staying with you to help, at least for the first several days. Trust me on this. Thankfully we’d already planned on my mom coming to help, but I will freely admit that my expectations for this surgery recovery were not realistic. I needed round-the-clock care for at least a week. More on that below, but I was wrong. You need help.

Check your house for tripping hazards, like rugs that will trip you or furniture corners that will be hard to get the walker around. Wash your sheets the night before your surgery, make sure all your towels are clean, and get a night light in your bedroom if you don’t have one, as you’ll have to get up multiples times at night and you won’t want to turn on a bright overhead (I have this amazing “wake” light that’s red tones and is super soothing).

Now let’s talk gear…

• I confirmed with my surgeon’s office ahead of time that they’d provide the walker. They were adamant that it be the super basic two-wheel version for safety reasons (I later realized why); my insurance mostly covered this
• I bought a cheap foldable cane, initially because I had to fly a week after surgery and I thought it would help me get from the wheelchair to the plane. But let me tell you, I used this baby SO much later after I transitioned off the walker.
• In hindsight with as much as I used the cane, I’d have been tempted to also get a more supportive one, as the regular one put an immense pressure on my palm and wrist cartilage, which I’ve injured in the past. But I’ve made do with the regular one.
• My mom brought me this four-wheel walker (an extra loaned from an elderly lady she looks after), and around the two- or three-week mark I started to use it around the house since it let me transport things easier. I’m not sure if it would be worth buying, particularly if you live with someone who can help. I live alone.
• My leg pillow situation was fluid. I had and used both a single-leg and a double-leg elevation pillow, both sitting on the couch and very much for sleeping. I also used a regular pillow sometimes.
• This is totally optional, but I decided to do a couple weeks of Juven after the surgery…it’s a supplement mix that’s supposed to help promote faster wound healing.
• You will definitely want to ice your hip frequently (we did 20 minutes every hour). My surgeon’s office gave us huge squishy ice packs with a kind of wrap/sling around the hip, but make sure you get some of your own if they don’t provide them.
• I’ll talk about bandages and other wound care tips later, but that’s critical, and these 4×8 ones were a lifesaver.
• I didn’t end up buying or needing a toilet seat raiser.

Surgery day

Your surgeon will give you detailed instructions for the day of surgery, but this usually includes not putting on any lotions, makeup, etc., no jewelry, and not bringing much to the surgery center (I did bring my Kindle as there was quite a bit of waiting around time before and after). You’ll want to wear loose comfy clothes, and I strongly suggest something a bit warm, or make sure you bring an outer layer.

You’ll likely have to fast all food and likely all liquids (including water) starting the night before your surgery. I recommend bringing an insulated mug of herbal tea or coffee for when you wake up…I was FREEZING. Like seriously teeth-chattering full-body shivers. They put like 7 blankets on me and it still didn’t warm me up.

They did a saddle block on me and twilight sleep, vs. general anesthesia. This is my surgeon’s preference, as they believe it means less pain (they said “minimal on day 1”). This was definitely not my experience, however. I woke up and had quite a bit of pain right away, and for some stupid reason my body decided to “un-numb” from the hips down to my feet rather than starting at the feet and working up. In fact, it took my feet forever to regain feeling and function, and I couldn’t go home until they did.

Once they did, the nurses had me get up and (using the walker and with their help) do a small amount of walking. This was an hour or two after my surgery. I was in quite a lot of pain and discomfort pretty much right away, and the pain pills didn’t really help a ton. That’s because I think a lot of it was nerve pain…like that feeling when you slam your funny bone, except traveling randomly up and down my leg constantly. More on that later, as I think there were specific reasons for it.

(Note, this is a pic from a previous surgery, ignore the mask but everything else is accurate…)

Beginning your recovery + some TMI tips

It’s important to drink tons of water in the couple days leading up to surgery, and also during your recovery (I always add a bit of electrolytes to mine). Eat gentler, easy to digest foods on your first day after surgery, to make sure you don’t have nausea after anesthesia, but then I recommend a healthy diet high in lean protein, vegetables, healthy fats, & Vitamin C. They did make me take an antibiotic for 14 days despite saying I wouldn’t have to, so make sure to use S. boulardii immediately and start using a probiotic (plus a good yogurt, etc) as soon as you stop the antibiotic.

If they don’t provide one, make sure you make a simple medication chart and always record when you’re taking meds. Early on I was on a handful of different things including the pain meds every 4 hours, antibiotics, baby aspirin, etc., and it’s easy to forget you took something or let the pain get ahead of the meds. For me a lot of the pain was nerve pain, though, which the Percocet and Tylenol unfortunately didn’t touch.

POOPING. They prescribed a stool softener for me but I didn’t take it right away. I tried more natural things, and honestly didn’t even feel like I *needed* to poop but it had been 5+ days and I knew I was super blocked up. I didn’t even feel any urgency, it wasn’t like my body was trying and I couldn’t…I think it may have been a holdover from the saddle block. So by the time I really started addressing it, things had gotten bad. I tried both natural things and the stool softeners, and nothing was helping, so I finally took Miralax. Which is a nuclear option, but I’m wondering if I’d taken it once or twice earlier on, whether that would have solved my problem and then I could have relied on my natural options moving forward. FYI, wiping is difficult and painful from a mobility standpoint.

If you’re still menstruating, I strongly recommend trying to schedule your surgery as far from your period starting as possible. Which I did. And then my cycle decided to jump forward a week and start like on day 2 after my surgery. UGH. Period underwear was a lifesaver (I use both Knix and Thinx), along with biodegradable body wipes.

I always wore lounging pants or shorts with pockets, which helped being able to transport small stuff whenever I moved around (like my airpods, phone, chapstick, etc). You will need to get up every hour to walk around.

Week 1 of my hip replacement recovery

Week 1 was ROUGH. I was in a lot of pain and discomfort, and the pain meds didn’t really seem to be helping a lot. Eventually the doctor said I should take extra Tylenol on the off-times, but that didn’t really help much either. For context, I’m usually off pain meds within 24 hours of a surgery, as they don’t help much and make me feel awful. Thankfully these didn’t make me feel terrible, but I also don’t know if they helped…but I kept taking them for a week and a half.

Icing and elevation are critical for accelerating recovery. Per the surgeon’s orders, I iced constantly (20 minutes each hour), using the ice wrap they gave me. I elevated pretty much 24/7, using the leg pillows or regular pillows I mentioned above. Rest as much as possible, other than getting up every hour to briefly walk around. Even if you’re feeling pretty good, don’t overdo it!! I also had to wear compression hose for two weeks , and FYI I could never in a million years have gotten them on myself, so make sure you have help for that whenever you end up showering. I also had to wear ankle pumps when sitting for longer periods, and when sleeping (not for being up and walking).

I asked a ton of questions ahead of time “what position will I be able to sleep in, sitting, toilet, etc?” and the answer was always “whatever is comfortable/you can tolerate”. Which…isn’t super helpful. The one thing they don’t want you doing is a front hip flexor stretch, and you definitely can’t be on your stomach.

Sleeping, in particular, was so hard. I’m not a good sleeper anyway, and I can’t sleep on my back but had to for the first few weeks after surgery. I had to wear motorized ankle pumps at night for the first two weeks (I think? maybe a month?), to help prevent blood clots while sleeping since I wasn’t getting up every hour. I did have to set an alarm for every 4 hours to take my pain meds and I’d get up and walk around for a minute, and use the bathroom. I used one of my leg pillows or sometimes a shorter regular pillow to elevate my legs while sleeping.

I was SO sweaty sleeping on my back for some reason. I don’t know if that’s just…sleeping on my back, or because my body was trying to detox the anesthesia and pain meds (I have a double MTHFR mutation that gives me a 70-80% reduced detoxification capability, and in particular Tylenol is awful for me).

Walking around (using the two-wheel walker) was slow but doable. This one is more stable than the four-wheel kind, and it’s important that you can place yourself in it and rest your weight on it—the other would have been impossible to use. But MAN, my wrists and hands hurt. Obviously avoid stairs when possible, but if and when you have to do them, you want to us your surgery leg first when going downstairs, and your good leg first when going upstairs.

I was finally able to shower 4 days after my surgery! WOOT. Thankfully I have an easy shower to get into (not slick, I didn’t have to step over anything), but consider whether you need a non-slip mat.

After day 4, when I was allowed to shower, I had to start changing my incision dressing every day for a month. This was awful, because my skin is quite sensitive to adhesive and the island dressings they recommended and provided were already making my skin have a rash and even bleed by the second time changing them. I ordered a ton of different bandages on Amazon and also at a medical supply store, and we tried a few different options (including Tegaderm, which did okay but was definitely a two-person job to apply), but thankfully I found these 4×8 silicone dressings that are not cheap, but were a lifesaver. I truly mean that.

Also, if you don’t know about lymphatic drainage massage, you should definitely check it out. I get this regularly for other health reasons, but it is SO valuable after surgery. It helps reduce swelling, bruising, speeds healing, and overall improves your recovery times. I started doing it weekly a few days after surgery and it helped immensely, just make sure the person you see is certified and experienced with post-surgical care.

Heading into week 2

First off, continue to remind yourself that recovery isn’t a linear process. There are ups and downs, great days and setbacks, or just a period of time where you feel you’re not progressing the way you wanted. Be patient and gentle with yourself.

In my second week after hip replacement surgery, I had some good and bad days, but I was UNCOMFORTABLE. Still some nerve pain, but also just couldn’t get comfortable to save my life. I felt like a 9-month pregnant woman just fidgeting around trying to find a comfortable position. In week two post-surgery, your serotonin levels drop, so feelings of vague anxiety and discomfort are common (I can say this from previous surgeries as well!).

And, to make things harder on myself, I had to fly to Kansas exactly one week after my surgery for my sister’s wedding. My mom had been staying with me to care for me, but had to drive home the day before I flew home, and so I had one day before flying to figure out how to minimally care for myself. And I was quite nervous about the physical challenge of flying.

So here are my tips for flying a week after hip replacement surgery…absolutely use the wheelchair assist option at the airport! Even if you feel like you’re getting around well. I was so thankful for this, and even used it in Month 3 for layovers in huge airports (Amsterdam, Atlanta), as you’d be shocked how easily you still tire when needing to get through a big airport quickly. Dress comfy, and pack as lightly as possible. Thankfully I could send my carry-on suitcase with my mom (who was driving the 11 hours) and so just brought a backpack with me. Get an aisle seat if at all possible, as it’s harder to scoot into the other seats.

I continued using my two-wheel walker this week, but did occasionally use the four-wheel one when on my own at home, to transport my coffee or a plate of food. I didn’t use the cane except to get from the wheelchair to my seat on the plane when traveling, and FYI you use it (counterintuitively) on your good side, so it acts as an extra leg that way. The cane is mostly for later recovery, once you can stop using the walker.

I had a gnarly bruise on my kneecap that kept getting bigger and hurt quite a lot. I think I probably had a small bruise but the blood thinner I was taking (baby aspirin) made the bruise keep growing. So be careful of bruising, as it will have an out-sized impact.

I finally slept all the way through the night at the two-week mark (as I wasn’t waking up to take meds), though it was still not great sleep quality and I was still super sweaty. I was *close* to sleeping on my side by about the two-week mark (and could get there for a couple hours sometimes, but not truly THERE…even approaching the end of week three wasn’t quite there).

Weeks 3 & 4 (first month after surgery)

Things really started to smooth out at this point, though I was still having a lot more mobility struggle and general pain and discomfort than I would have expected at this point. It didn’t help that I injured myself slightly on my flight home (late week 2), just instinctively shot out my (surgery) leg to catch something that was falling, and so had some microtears and bruising that set me back a bit and made week three a bit more challenging. I also had a couple of worse pain/soreness/discomfort days right at the end of week three for some reason.

Some things were definitely getting better—for instance, walking around with my walker was smoother and I was needing to put less body weight on it. My overall mobility (lifting my leg up onto the bed, etc.) was definitely improving. On the flip side, getting my bottom half dressed (pants, socks, etc) was still SO hard…honestly, even 3 months in that’s still a challenge now.

They don’t want you walking without the cane or walker until you can do it smoothly without limping or hobbling at all. However, since I live alone I found myself hobbling a bit here and there, like between kitchen counters as I prepared a meal. This is okay overall.

I also started a couple weeks of in-home PT in week three (probably should have been week two, but I was traveling, and getting it set up was confusing). This was just having him make me do my exercises, watch me walk some, he took my vitals and also offered me thoughts and answered questions. It was nice to have at that stage, someone to give his perspective on how I was doing and also get questions answered easily. Because I didn’t go in for a follow-up visit with my surgeon until the six-week mark!

Every surgeon will be different, but PT was not a big part of my recovery process. They say the #1 thing they wanted me doing was walking. Yes, I had some exercises and I did them religiously, but walking was the most important. I do plan to do some specialized PT around the three-month mark, more to help re-train my muscles, form, and gait for walking, running, and weight lifting.

They say you have to be off the walker, off a cane, and off pain meds to be cleared to drive. I was…kind of mostly there on some of that?? But guys, I live alone, and can only find rides so much of the time (and I’m not in an area with easy Ubers). So I started driving mid/late week three. I was using the four-wheel walker mostly at this point, and that was easier for errands like getting groceries. I am actually a good left-footed driver (due to many past right ankle injuries), and so did that early on since my right hip wasn’t up to slamming on the brakes if needed.

By the end of three weeks I was working to transition from the walker to the cane (I was in-between). I had my first night mostly sleeping on my non-operative side (I am a side sleeper 100%) with a thin pillow between my legs. I was doing my exercises and clearly gaining strength, but wore out easily and still had some pain.

At four weeks, all of this was incrementally better. I was able to stop changing the incision dressing (yay!), and had mostly transitioned to the cane but was still using the walker on occasion.

Month 2 after hip replacement (weeks 5-8)

Okay, let’s talk about the second month after a hip replacement. I really felt like week five jumped forward…I was moving fairly quickly toward walking (still hobbling, but more evenly and less painfully without the cane). I started going on short walks in my neighborhood, like literally two driveways down and back, but still 🙂

In week six the hobbling was getting smoother and less painful. I was starting to sleep on the operative hip side some as well! Around and after the six-week mark, my mobility was improving beyond just walking as well. A lot of movements that were quite painful and challenging in my first month (like high knees, lifting the leg, bending the knee while sitting on the couch, etc) were giving me minimal or no pain at this point.

However, any kind of bending at the hip while bending the knee (e.g. to shave my legs, clip toenails, etc) was still impossible, and putting shoes and socks on that leg, any kind of butterflying it out to the side while bent, trying to cross my operative side over the other, etc. was a HARD NO.

I have an infrared sauna at home and do it regularly, and was able to begin sauna at about the 5-6 week point (closer to 6 weeks). You need the incision to be fully healed skin and have no scabbing at all. This was the same point at which I was able to start using scar cream and scar tape on the incision as well.

At my six-week surgeon follow-up, they were really happy with how I was doing. I had developed pockets of either fluid or fibrous tissue above the incision, not worrying but I’ve been trying to use arnica, lymphatic massage, and my own myofascial massage to decrease that over time. The PA was impressed with the one “test” she did, which was having me raise my knee (in sitting position, so high knee raise above the table) and she pushed down on it, didn’t move. She also said that my shin splint-like pain that I was having is normal, it’s the nerves reconnecting.

Month 3 after hip replacement

As I headed into my third month, things were going well. I was walking pretty normally in my day-to-day puttering around the house, though early in the month was having trouble building up my longer walking. It wasn’t technically the front of the hip causing me pain, but some way I was walking or “baby-ing” the joint was giving me major sacro-iliac pain (a common issue for me). This eased by about week 10.

What else happened around week 10?? Ha…well, I went to Croatia. For a sailing trip. Which was insane and also awesome. My surgeon had no concerns, it was just a “whatever you feel up to”. I honestly didn’t know *what* I’d feel up to at that point when I booked about a month out, but desperately needed a trip and didn’t want to pay summer Europe prices (I snuck in last week of May, which was still dumb expensive).

The great news is that my trip was both very challenging physically and also went very well. I still used my cane through the airports and made use of the wheelchair assist on my connections (tight layover + big airport is a nightmare when you have limited mobility and are dragging luggage). I’m so thankful I did that, it made life so much better. Sitting in a chair was not painful at this point, so the flights weren’t bad, and I wore compression socks and got up frequently to stretch and walk around on the long flights.

One note, with a fake hip joint you’ll need to let any security screening people know and probably can’t go through a metal detector successfully. I always let them know in the TSA screening line and they send me to the x-ray scanner instead.

Moving around the sailboat and helping with the lines, getting in and out of the dinghy, etc. could be very challenging with where I was in my recovery, but I made it work and I think it and walking around the cute towns challenged my new hip and probably strengthened me at that point in my recover.

My surgeon said I could do whatever I felt up to EXCEPT running, jumping, or other high-impact activities. These needed to wait until after the 3-month mark. I haven’t gotten back to any of those yet, but am ready to start up my YMCA Bodypump classes again. It takes a full year to be TRULY fully recovered, though at 3 months you’re mostly there…like 80% of the bone growth is where it needs to be and that’s when you can start doing some high-impact stuff if desired and if your body will let you.

I’m currently right at the three-month mark, so will update this post as time goes on, if there’s more to share.

What I wish I’d known before hip replacement at age 40

So to give you the TL;dr version…

• Younger people are likely to have more pain and a more challenging recovery early on from hip replacement due to having more nerves, muscle mass, and soft tissue
• Everyone’s recovery is different, and it’s not linear. You’ll have good days and bad days, some things will heal faster and others will linger. Be patient and give yourself grace.
• Anterior surgical approach is considered less invasive and quicker-healing; ask your surgeon which they do!
• Do not be afraid to ask for help! I strongly recommend having someone stay with you for at least a week, but you’ll need help running errands, getting to appointments, etc. for the first few weeks.
• Take your recovery seriously. Eat healthy, make sure you’re getting enough protein and vitamin C, hydrate well, rest as much as possible, and do your exercises! Elevation and ice are also really important.
• I’m a huge proponent of lymphatic drainage, and recommend you look into it.
• The first couple weeks were super rough for me, but weeks 3 and 4 I could start seeing the light at the end of the tunnel.
• By month 2, I could really see my progress, though I still had some things that were really challenging.
• Month 3 is more of the same. Push yourself somewhat, have days where you do more and stress the joint a bit more, then rest the next day…this is the same approach you might take in working out, to stress then rest, allowing for greater healing and strength-building.

So I know this was long, but hopefully parts of this were super helpful as you contemplate hip replacement recovery—particularly as a younger person. What questions haven’t I answered? Drop me a note, I may not have the answer but I’m happy to provide anything from my experience that could be helpful!

I have a similar deep-dive post on having bunion foot surgery recovery, if it’s helpful.

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