A double hip replacement at 22? ‘I was shocked.’

The day before her double hip replacement, Avery Molnar couldn’t do anything but lie on the couch and cry.

It was an unlikely place to be for the previously active 22-year-old Charlotte woman. In the months leading up to that tearful day, Molnar’s pain had grown progressively worse. She first noticed it during the long walks she’d take with her poodle mix, Remi.

Both hips hurt on those walks that started in August 2022, but the right hip was noticeably worse. Eventually, the pain became debilitating. By late last year, she had to stop the walks entirely. Her dad, A.J. Molnar, took over walking Remi, who was by then accustomed to long treks.

Molnar also had to give up TV nights with her dad. “Me and my dad always watch Netflix upstairs at night,” she said. “But I couldn’t even get up those stairs.” They had to settle for watching basic cable TV downstairs instead.

Molnar endured the pain, with Aleve and ice packs, from when it started in August 2022 until she saw her primary care doctor, Dr. Augustus Parker of Novant Health Blakeney Family Physicians, in January 2023. “At its worst, I could still walk – but with horrible pain,” she said. “I would only go places where it did not require much walking.”

She was even forced to stop going to the gym, which was something she loved. She’d become a weightlifter over the past couple of years, but had to give it up, too. (She’s been cleared to start lifting again and hopes to resume soon.)

She was a full-time graphic design/media arts student taking online classes at Southern New Hampshire University. Trying to keep up with school while enduring extreme pain wasn’t easy. But she graduated on time – and summa cum laude – this spring.

Her condition and her level of pain – which became constant – required something drastic you seldom see in someone her age: She had both hips replaced. But the young woman who was adopted when she was almost 2 from an orphanage in Pune, Maharashtra in India, is thanking God again for helping her rise above towering challenges.

‘The only good option’

Her primary care doctor referred her to a sports medicine doctor, who ordered an X-ray. “He called me the next day to say he saw evidence of avascular necrosis,” Molnar said. An MRI confirmed the diagnosis.

She made her way to Dr. (David) Homesley, Jr., of Novant Health Orthopedics & Sports Medicine - Cotswold. He specializes in joint replacement and she became his youngest-ever hip replacement patient.

“With avascular necrosis (AVN) of the hip, the blood supply to the femoral head – the ‘ball’ of the ball-and-socket joint – is cut off, and the bone dies,” the surgeon explained. “It can no longer support the cartilage and collapses. Avery developed arthritis as a result.”

Homesley told Molnar’s dad that the cartilage around her hip bone looked like orange peel coming off a piece of fruit.

Only between 10,000 and 20,000 Americans develop avascular necrosis every year. It can affect someone at any age but is most common in people in their 30s and 40s.

“About 90% of the time, we don’t know what causes AVN,” Homesley said. “Among the 10% where we do know the cause, it’s more common in patients who’ve been on steroids for a medical condition and among heavy alcohol users."

Homesley wondered if Molnar’s AVN could be genetic. But since she was adopted, she doesn’t have access to her birth family’s medical history.

Most orthopedic surgeons will tell you surgery is always their last resort. But there were no other options for Molnar. “Sometimes you can treat AVN with a core decompression, where we drill into the bone to try to recreate some blood supply and prevent collapse,” Homesley said. “But once it collapses and there’s arthritis, the only good option is a total hip replacement.”

And given her level of pain and the fact she’d lost cartilage in the joint, it needed to be done quickly.

“I was shocked because I’m so young,” Molnar said. “It was scary. I’d never had surgery, so this was a big one to start with. But I trusted that God had a plan, and I knew he’d handle it.”

During her first visit with Homesley, he told her “God was in charge,” and she knew she was with the right surgeon. “That brought me so much peace,” she said. “I could take a big, deep breath, knowing we were on the same page.”

Homesley offered to perform two separate surgeries, but Molnar wanted to get them over with at the same time.

“It’s pretty rare to do both at the same time, since doing one is a major operation,” Homesley said. “We make sure both hips are equally ‘bad’ and that the patient is healthy enough to do both at the same time.”

By the time her surgery was scheduled, her pain was consistently at a 9 on a 10-point scale. “I could walk if needed, but I preferred not to,” she said. A pair of crutches she got from Homesley’s office helped her get around in the weeks before surgery.

Recovery (and room service) at the hospital

Her surgery was scheduled at Charlotte Orthopedic Hospital within two weeks of her initial visit with Homesley. She was in the hospital three nights – March 6 through 8. After waking up from surgery, Molnar recalls being wheeled to her room and seeing her parents walking in at the same time. “I immediately asked how my dog was,” she said.

One of the bright spots of her hospital stay was an accommodating team member she called “Chef Anthony.”

“He came in one day to give me options for dessert that night,” said the self-described “picky” eater. “I didn’t care for any of the choices, so I told him I’d skip dessert. But then he asked what desserts I did like. I told him it was fine, but he kept asking. Finally, I said I really like chocolate chip cookies. And that night, when he brought my meal, there were two chocolate chip cookies on the tray. That went a long way to making me feel cared for.”

Anthony Grimes is not a chef, but rather a dining associate who delivers trays to patients. His manager, Robert Stamper, wasn’t surprised that Grimes had gone out of his way to make a patient happy.

“We try and please all our patients,” Stamper said. “Anthony works hard on his floor and gets compliments from patients all the time about going the extra mile.”

“Recently, a patient who’s legally blind told me, ‘The food has been great, but Anthony has been amazing.’ Every time Anthony delivered his meal tray, he would set it up and go over where each item was on the tray and open any items (that were sealed). This is how Anthony works with and treats all his patients.”

Getting support

Chocolate chip cookies were a sweet reward for all the hard work Molnar had to do in the hospital as part of her healing.

“They want you out of bed the same day of surgery,” she said. “I remember standing up, walking to the front of the bed and feeling nauseous and light-headed. I got right back in the bed.”

There are a few other things patients must check off – before they check out.

“The first is going to the bathroom by yourself,” Molnar said. “You also have to be able to change your clothes. In physical therapy, they made sure I could make it up one step because I have just one step to walk up to get to the front door of my house. In physical therapy, they have a fake car, and you have to learn how to get in and out of the car. You can't just hop in the car like a normal person would. You kind of slide in. And they made sure I could walk with a walker, which was definitely my best friend for a little while.”

Within a month of surgery, Molnar was walking again. “I still have some pain, but it’s nothing like before,” she said. “Now, I can walk without pain. I can go up and down steps without pain. It's crazy how fast the body recovers.

“A few weeks after surgery, my best friend came home from college,” she said. “She knew I was going stir crazy inside, so she insisted we go to Starbucks. I was still using my walker and hadn’t gone out in public yet. And I was like, ‘I don’t want people seeing 22-year-old me using a walker.’ Having her support and having her push me really meant a lot. And the walker turned out to be no big deal.”

Molnar, who’s looking for her first job in her chosen field of graphic design, is back to walking Remi. They can go for about a mile and are working up to longer walks.

Molnar’s necrosis is gone, and the only limitation Homesley cautions hip-replacement patients about is “that the pounding that comes with running and jogging will wear a replacement joint out faster.” He expects her new hips to last for 20 to 30 years.

Molnar recently had a follow-up visit with Lori-Ann Hart, Homesley’s physician assistant, who told her it may take up to a year to fully recover. “But I’m pretty close to not feeling any pain at all,” she said. “With all the help from the doctors and my family and friends, recovery has been easier than it might’ve been. My parents and I trusted that God had a plan, and he did. It’s all good now.”