Moderate to severe osteoarthritis of the left hip.
What I learned from having a hip replacement at age 39
I was taller than most of the boys growing up, and to be frank, I still am. My dad encouraged me to sign up for all the co-ed sports teams (i.e., boys’ teams with one girl on the roster—me). I loved being an athlete. I played volleyball through high school and later became addicted to group fitness classes and hiking.
At age 32, I started bodybuilding, chasing strength and physique gains. So when I began waking up in the middle of the night with deep, left sacroiliac (SI) joint pain in my mid-30s, I blamed the deadlifts and overtraining. I brushed it off and pushed through.
Physical Therapy
When all was said and done, I was prescribed gabapentin and left with more questions than answers. I started to lose faith in doctors and, instead, turned to a skilled physical therapist. She took one look at me and noticed that my pelvis was torqued out of alignment and internal rotation of my left hip was severely limited.
We made a lot of changes to my training routine, and I faithfully did my physical therapy (PT) exercises three times per day for months. I improved enough to complete a 52-mile hike through Chilean Patagonia. But shortly thereafter, acute anterior groin pain emerged.
In February 2024, I saw an orthopedist who ordered an MRI of my left hip and lumbar spine, which revealed an acute left labral tear, as well as severe osteoarthritis of the left hip. There was some mild facet arthropathy in my lumbar spine, but not much else. I was sent back to PT—again.
By this point, I was doing 20 minutes of PT exercises every morning just to function, and my life had shrunk. My five-day a week weightlifting routine and avid hiking hobby had dwindled down to barre class and walks, which I often had to cut short due to pain. I couldn’t sit on the floor, tie my shoes or roll over in bed to reach something on my nightstand without pain. My sex life was affected. I assumed I just wasn’t resting enough.
Then came a family ski trip in January 2025. I was an excellent skier, but my body just couldn’t handle it. I was in debilitating pain for weeks.
I remember lying on the floor after a day on the slopes, doing yet another set of PT maneuvers, when a friend gently said, “Sam, you’re too young for this. Don’t give up. Get another opinion.”
The Breakthrough
Despite presenting with low back pain, my physical therapist and I eventually hypothesized that my hip was the root of the problem. My hip internal rotation was severely limited due to arthritis. To compensate, my body had gotten creative and started torquing my pelvis to work around the limitation, dumping additional stress into my left lumbar spine and SI joint.
This February, a new orthopedist looked at my imaging and said, “Has anyone explained why this happened to you?”
“Years of bodybuilding, stubbornness and ignored warning signs,” I replied.
“No, Sam, you have hip dysplasia. Tearing your labrum led to rapid worsening of your hip arthritis because that protective layer was no longer there. You actually did everything right—stayed active, lifted, protected your joints. This isn’t your fault.”
He offered an intra-articular steroid injection for both diagnostic and therapeutic purposes, noting that he’d think twice about operating on my hip if it didn’t solve the SI joint pain, too. The steroid felt like a miracle. I was completely pain free for seven glorious days.
He consulted a few colleagues to ensure that total hip arthroplasty was the right move—especially given my age. We decided it was, and my surgery was scheduled for May.
As I write this in June, I’m seven days post-op. My surgery went swimmingly, and I walked out of the hospital the same day with the help of my partner, mother and a walker expertly decorated by my best friend. My left leg is still quite swollen and tender, but my SI joint pain is gone. I’m tapering off pain medications day by day.
If all goes as planned, I’ll return to the gym in eight weeks, hopeful for a 90% recovery by week 12.
What I Learned
The short answer? A lot. The longer answer I’ll break down into 10 key points.
1. Arthritis Leads to Grief
Over the past three years, I’ve cycled through the five Kübler-Ross stages of grief:
- Denial (i.e., “It’s probably just my deadlifts.”);
- Anger (i.e., “Why me? I take care of my body!”);
- Bargaining (i.e., “If I just rest more, maybe it’ll get better.”);
- Depression (i.e., “I’ll never get better.”); and
- Finally, acceptance (i.e, “I will need to learn to live with this.”).
Grieving the loss of who I was physically was just as real as grieving a loved one. It came with identity shifts, social withdrawal and deep sadness.
2. Arthritis Forces You to Play Small
Bit by bit, my world contracted. I went from multi-day mountain treks to choosing walks based on the shortest route home. I started making decisions based on how long I’d have to sit or stand, instead of what I actually wanted to do.
The impact of this loss of freedom is easy to underestimate when caring for patients.
3. The Definition of Quality of Life Is Different for Everyone
Sure, I looked better than a lot of patients who undergo total hip arthroplasty. I could still walk. I could still do some types of exercise. But to me, this wasn’t acceptable. I was an active athlete and wanted to continue to be one.
4. The Value of a Second Opinion
I wasted months—maybe years—thinking this pain was just the price of overtraining and that I just had to learn how to live with it. But persistent support from my physical therapist and community inspired me to keep searching for answers.
5. Joint Pain Sucks
No amount of rheumatology training prepares you for the lived experience of chronic joint pain. It’s isolating, exhausting and all-consuming. Now when my patients say they’re tired, hopeless or short-tempered, I understand with lived empathy, not just clinical sympathy.
6. Uncertainty & Lack of Hope Suck
Before I had a diagnosis, every day felt like a roll of the dice—trying one more stretch, modifying one more activity. The ambiguity was almost worse than the pain.
As clinicians, we underestimate the power of saying, “This is what I think is going on, and here’s what we can try next.”
7. A Good Physical Therapist Is Worth Every Penny
My physical therapist never gave up on me, even when it felt like we were stalling. She adapted and adjusted, always thinking critically. She celebrated my wins and held me when I cried. Her compassion, creativity and persistence were more impactful than any medication I took.
8. ‘This Isn’t Your Fault’ Is One of the Most Powerful Things You Can Say to a Patient
When the orthopedist told me this, a weight was lifted. I had internalized so much shame, and it was only making things harder to carry.
As clinicians, we need to remember that patients often carry guilt—consciously or not—and absolving them with compassion can be a turning point in their healing.
9. Invest in Community
Have you ever heard the phrase “don’t wait until your house is on fire to meet your neighbors?” I was lucky in this regard. I had already built deep friendships in Austin, and this experience reminded me how essential it is to nurture those relationships long before you need them.
When I went down, my people stepped up.
10. Ask for Help
Before surgery, I sent a text message to all my local friends, asking for post-op support with some specific requests. People want to help, but they often don’t know how unless we tell them. That one text led to more visits, meals and laughs than I can count.
Harley the Hip!
Silver Linings
Arthritis broke me in ways I’d never expect. But I’m healing and not just because I have a new hip. This experience taught me how lonely pain can be, how powerful it is to feel seen and heard and how much hope a clear path forward can bring. This experience taught me that I am loved. I’m infinitely grateful to my partner, my mom, my physical therapist, my surgical team and my community for holding me up when I couldn’t do it myself.
Also, my new hip’s name is Harley.
Samantha C. Shapiro, MD, is a clinician educator who is passionate about the care and education of rheumatology patients. She writes for both medical and lay audiences and practices telerheumatology.
