Total Hip Replacement at 19 Years Old

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I had my right hip replaced in the summer of 2009. Unlike most individuals who undergo the elective surgery, I was only 19 at the time. I had been suffering from progressively worsening hip pain over the previous two years that made it impossible for me to walk even short distances without a very noticeable limp. A combination of the pain, embarrassment of constantly being questioned by my peers about my awkward gait, and the encouragement from my parents led to the inevitable surgery between my freshman and sophomore years of college.

The reason for having my right hip replaced differs significantly than the vast majority of people. I had a condition known as Avascular Necrosis which is essentially bone tissue death due to a lack of blood supply. AVN may be caused by trauma, excessive alcohol consumption, or other conditions, but it is most commonly seen in younger, active populations secondary to corticosteroid use. Cases of AVN have been reported from both short and long-term usage of corticosteroids across various applications. However, the exact mechanism behind this condition is unknown and it is likely to be multifactorial in nature. Unfortunately, a high oral dosage of corticosteroids for 3 years to combat a separate medical issue likely led to my development of AVN.

“Will I be able to lift weights?” It’s one of the few questions I remember asking my surgeon. He told me that I would be fine squatting up to 135 pounds because there were individuals much heavier than me who put that amount of stress on their implant with their normal day-to-day activities. That made sense to me. He told me that I could be active like a healthy young adult. He wasn’t encouraging or expecting me to go out and play tackle football, but I think he was giving me the freedom to be responsible with my choices. We also talked about some of the risks associated with high-impact activities. The only thing I distinctly remember him telling me to avoid was bringing my right knee beyond my left shoulder to minimize my risk for dislocation (which I can’t do anyway).

Here’s a short list things of things I’ve done since my total hip replacement:
- Hiked all 22 miles of Mt. Whitney (14,505’ elevation) in one day.
- Wrestling and boxing
- Basketball, soccer, flag football, softball, ultimate frisbee, tennis, volleyball
- Yoga, paddleboarding, skateboarding, ice skating
- Deadlift 2x bodyweight for 10+ repetitions
- Bulgarian split squat 185 pounds for sets of 3

Are these amazing feats of strength, skill, or endurance? Not for many, but it’s a glimpse into what can be done with an artificial hip.

Were all of these activities pain-free? No, but the discomfort of repetitive hip flexion as I ascended Mt. Whitney was worth the feeling of accomplishment at the top.

Do I still perform all of these activities? Yes and no. I’ll happily play sports on occasion, but I can’t bring myself to be as competitive as I used to be. I don’t jump as high for a rebound or run as fast to catch a frisbee.

I’ve decided that I’m going to lead an active, healthy lifestyle, but I’m going to do so while keeping my future in mind. There’s a lot of uncertainty about the longevity of the implant. If I can potentially extend the time until I need my first revision by minimizing high-impact activities, that’s what I’m going to do. It doesn’t negatively affect my quality of life.

I am not recommending that individuals with a total hip replacement perform any of the activities mentioned. I am simply describing my experience over the past 11 years.

Should you return to high-impact exercise? I think that’s a discussion to be had with your surgeon, physical therapist, and family. Is the risk of possibly needing an earlier revision worth the 10 years of marathons in the prime of your life? You might say yes. As I mentioned earlier, it’s not worth the risk for me anymore. My goals have changed and I’ve come to accept that.

If you had no goals in mind and just wanted to be as healthy as possible, I would recommend a wide range of exercise: walking, cycling, hiking, resistance training, etc. Most people are not meeting physical activity guidelines as it is and it’s one of the healthiest things you can do for yourself, so the last thing I want to do is discourage people from exercising. I train hard consistently while staying on the low-impact side of things with very minimal pain.

Can you return to high level activities? Absolutely. Should you return to preoperative amounts of high-impact activities? It’s not a black and white, yes or no answer. It’s grey. It’s complex. I don’t think there is one right answer. We’ll see how my hip is doing in another 11 years.

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Disclaimer: The information presented is not intended as medical advice or to be a substitute for medical counseling but intended for entertainment purposes only.