I had my first hip done when I was 46 due to really sever arthritis. I'm now 71 and had the 2nd hip done 11 years go. I was hesitant back in 2002 - but it was the best thing I ever did. I went from barely being able to walk or lift my leg (bone spurs limited my hip movement). I went back to skiing (for a bit), hiking, biking, and tennis. I still play tennis (both singles & doubles) and lead an active life. My hips don't feel artificial. I understand about it being tough to strength train before surgery - but after surgery it's important your muscles strong again. And don't just concentrate on hip/core. remember to strengthen all muscles because you may have distorted the muscles you use.
Regarding referred pain... my 2 hips presented the pain the differently. My second hip I had a tight IT band and it caused bad knee pain for 2 years and included a hip bursa. I went to 2 doctors for opinions - both were considering doing a knee replacement due to the severe knee pain - but one really thought it was my hip causing the problem after he did a cortisone injection to review how I responded. I had the hip replacement in 2015 and the knee pains and IT band problems went away.
We are all different health wise - but my hip replacements were the best thing I did to be able to maintain an active life.
Side note - I do have asymptomatic metalosis (high levels of cobalt/ chromium) from the 2002 metal-on-metal hip. I was diagnosed 2 years ago and I now monitor annually. I have no regrets having my hip done in 2002... it gave me my life back.