Strictly Come Dancing judge Darcey Bussell recently revealed how her career as a ballerina left her in need of hip surgery at the age of 46. Despite having retired from dancing seven years ago, the former principal dancer for the Royal Ballet says the physical strain ballet placed on her body led to a recent hip resurfacing operation which she says has made a huge difference to her life.
Speaking for the first time about the procedure, which she underwent last year, mother-of-two Darcey (left) said: "I had the resurfacing because I was too young to have a replacement.
"A lot of retired ballerinas have hip replacements, but they usually wait until they are in their 60s, not 40s. I just think, look, how lucky are we that we can have titanium put in our bodies and it does wonders."
Hip resurfacing involves taking less of the bone away than if it was replaced, and the ball and socket are relined with metal implants. Resurfacing is also less invasive and easier to repeat later or follow with a hip replacement afterwards, but can need repeating after five years.
Hip replacements are usually carried out in older patients aged between 60 and 80 years.
However, while surgery in people under the age of 60 is still very rare it is not unheard of.
We talked to two local women who like Darcey - one who is just in her 20s and one in her 40s - who have come through the trauma of major hip surgery.
As a busy mum to a six-year-old and with a full-time career as a school teacher, Grace McDonnell has really struggled to come to terms with being off her feet due to hip replacement surgery.
An active and fit 46-year-old she endured excruciating pain for years while waiting for her operation which she finally underwent last September.
Still recovering at home in Portadown, Grace who is used to being on the go, is finding it difficult to take it easy as she allows her body to heal.
Her experience gives a real insight into the trauma of this type of surgery at a time in life when health and independence is something most of us take for granted. Ordered to rest completely and unable to bend for the first six weeks after the operation, Grace couldn't shower herself or even manage to make a cup of tea.
Although now back on her feet she still has a long recovery ahead with the added complication that the long wait for surgery could now have caused damage to her knees.
Grace, who is acting head of English at Cookstown High, is married to Brian (51), an estimator for a glazing company, and they have one son, Charlie, who is six.
She says: "I am a full-time teacher and the mum of a small child who is used to going 100mph so it has been really tough for me.
"I was 42 when I started having pain in my leg. The doctor put it down to sciatica and said it was coming from my lower back. But when it didn't get any better I eventually went back to him and he referred me for an X-ray."
That was two and a half years ago and the results of the X-ray showed damage to her hip which was so acute that she was referred to a consultant.
As she waited six months for an appointment she continued to work, even though walking was getting more difficult and she was in "excruciating pain".
The consultant told her that she had arthritis in her hip of a severity normally associated with people in their 60s and 70s and which was very rare in someone so young.
"I asked him what he was going to do to help me as I could hardly move and had a full-time job and a small child to look after," she says. "He told me to wear trainers and take pain killers as I was too young for a hip replacement op."
A horrified Grace insisted that she could not carry on and eventually was referred to another consultant. Again she waited six months for an appointment.
She had her consultation in January 2015 and recalls: "The consultant at Craigavon Hospital was superb. He looked at my hip and asked me how I was managing. It was so bad he couldn't believe I was still working but I didn't want to be off work and carried on - even though I was in excruciating pain.
"He told me I had just bone on bone at the joint and because I was an active young woman I needed the operation. He referred me for surgery and told me the waiting list was a year."
By May though, Grace was struggling so badly she contacted her GP and because her condition had deteriorated so badly she was moved to urgent on the list and given a date for surgery on September 7.
She underwent the three-hour operation in Craigavon Hospital and was sent home to recover after four days with strict instructions that she wasn't to bend for six weeks or drive for 10 weeks.
A full recovery was said to take up to a year, but within three months she would be mobile again and especially because of her age she could expect it to heal quicker. Unfortunately that hasn't happened.
"I assumed, maybe wrongly, that because I was a fit and healthy young person that I would recover quickly," she says.
"After three months I was able to get about and do things again but I am not pain-free. I have terrible pain in my knees and can't get up and down steps properly.
"I have been to my GP who has referred me for an early review as it is feared that the pressure put on my knees while waiting for surgery could have caused further damage.
"In some ways for me after the operation it felt like being hit by a car. I was preparing for the start of a busy school year and I had cleaned my whole house the weekend before the operation. Then I found I couldn't work anymore or move.
"You have to lie on your back for six weeks and you are not allowed to bend for fear of dislocation so I couldn't even make a cup of tea for myself.
"Only for my family, my husband and my parents and two of my best friends I don't know how I would have managed.
"My parents took Charlie to school and my friends came down and had to shower me. It was really traumatic. I think mentally it took me two to three months to come to terms with."
Grace has started Pilates and swimming to try and speed up her recovery and hopes to return to work in three months.
"It is a major upheaval and I am starting to get there now. I just can't wait to get back to normal life," she adds.
Elite young athlete Lisa Cardwell from Carnmoney was so young when she wore her hip down through exercise, that for a long time doctors were unsure how to treat her.
Lisa, who became the youngest ever black belt in judo aged 15 in 2009 and a silver medal winner at the Commonwealth Championships in 2006 aged just 12, was devastated to have to give up professional sport because of her condition.
Now aged 21 and studying criminology and criminal justice at the Ulster University, Lisa is currently recovering from surgery which she eventually went through at a specialist clinic in England last October after nine years of pain.
Her dedication to her sport, which she started aged four, caused her hip to wear down in a way which doctors said is usually only seen in elderly people.
Throughout her childhood and teens, dedicated Lisa trained seven days a week, getting up at 5.30am and training for two hours before she started school, with gym sessions in the evening.
She became the first person from Northern Ireland to represent Great Britain in Olympic Freestyle Wrestling at the European Championships in 2011, when she finished 13th.
As a natural young athlete on her way to becoming an elite competitor, she trained with the Performance Development Centre at the Sports Institute two and a half days a week while at Glengormley High School.
She had her sights set on representing Great Britain at the Olympics and has not given up hope of that dream, although she will have to wait to see how successful her surgery has been.
She explains how her pain developed: "It was after the Commonwealth Championships in 2006 that I first had pain in my hip.
"It was the odd niggle and nothing major, so I just put it to the back of my mind.
"Each year it was getting more and more severe and it got to the point in 2011 at the European Championships that it was so bad it was affecting my range and ability.
"I was only 17 and I went to my GP and he was adamant that even if I did need a hip replacement, I was far too young to get it.
"He told me that even people in their 50s were too young."
Lisa said she was told to take painkillers, which as an athlete weren't an option - even though the pain had become so bad that she wasn't sleeping at night.
In 2012, she was referred to an orthopaedic specialist and eventually sent to a specialist clinic in England, where many young sports people are treated.
She had her first appointment at the Wrightington Clinic in Wigan last June and after an X-ray, CT and MRI scans, was told that she had deep tears in the ligaments holding her hip together which were causing her hip to wear down.
She recalls: "I was told it was really common in elderly people due to wear and tear and it was because I was involved in extreme sport at such a high level that it had happened to me at such a young age."
Lisa underwent keyhole surgery in October, which was initially expected to last 45 minutes - instead she was on the operating table for three hours because her hip was so badly damaged.
Three months on and already she feels like a new woman and is hoping to get back to her sport.
She adds: "From what I was before the operation to how I am now, is like a miracle.
"It has changed my life. The pain went nearly immediately and my mobility is brilliant.
"I lived and breathed my sport and I didn't know any other life.
"When I had to give it up, I was heartbroken; I didn't know how I would fit in or what I would do with my time.
"Life didn't have the same buzz any more.
"I do miss sport and I feel I never got the chance to fulfil my potential.
"I would still like to go to Rio, but the worry is now that if I continue my sport I will damage my hip again, so I have to wait and see. I have a review at the clinic this week and I am just hoping for good news."