Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019 Feb 16;393(10172):647-654.
doi: 10.1016/S0140-6736(18)31665-9. Epub 2019 Feb 14.

How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up

Jonathan T Evans  1 , Jonathan P Evans  2 , Robert W Walker  3 , Ashley W Blom  4 , Michael R Whitehouse  4 , Adrian Sayers  5
Affiliations
Meta-Analysis

How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up

Jonathan T Evans et al. Lancet. .

Abstract

Background: Total hip replacement is a common and highly effective operation. All hip replacements would eventually fail if in situ long enough and it is important that patients understand when this might happen. We aimed to answer the question: how long does a hip replacement last?

Methods: We did a systematic review and meta-analysis with a search of MEDLINE and Embase from the start of records to Sept 12, 2017. We included articles reporting 15-year survival of primary, conventional total hip replacement constructs in patients with osteoarthritis. We extracted survival and implant data and used all-cause construct survival as the primary outcome. We also reviewed reports of national joint replacement registries, and extracted data for a separate analysis. In the meta-analyses, we weighted each series and calculated a pooled survival estimate for each source of data. This study was registered with PROSPERO (CRD42018085642).

Findings: We identified 140 eligible articles reporting 150 series, and included 44 of these series (13 212 total hip placements). National joint replacement registries from Australia and Finland provided data for 92 series (215 676 total hip replacements). The 25-year pooled survival of hip replacements from case series was 77·6% (95% CI 76·0-79·2) and from joint replacement registries was 57·9% (95% CI 57·1-58·7).

Interpretation: Assuming that estimates from national registries are less likely to be biased, patients and surgeons can expect a hip replacement to last 25 years in around 58% of patients.

Funding: National Institute for Health Research, National Joint Registry for England, Wales, Northern Ireland and Isle of Man, and The Royal College of Surgeons of England.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Article selection
Figure 2
Figure 2
Estimates of survival at 15 years, 20 years, and 25 years from case series
Figure 3
Figure 3
Estimates of survival at 25 years from registry annual reports
Figure 4
Figure 4
Comparison of pooled survival estimates from case series and registry reports at 15 years, 20 years, and 25 years The size of each circle is proportional to the total number of hip replacements at the start of all the series contributing to that pooled estimate.
See this image and copyright information in PMC

Comment in

References

    1. Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet. 2007;370:1508–1519. - PubMed
    1. NICE . National Institute for Health and Care Excellence; London: 2014. Total hip replacement and resurfacing arthroplasty for end stage arthritis of the hip. NICE technology appraisal guidance 304.
    1. Lenguerrand E, Whitehouse MR, Wylde V, Gooberman-Hill R, Blom AW. Pain and function recovery trajectories following revision hip arthroplasty: short-term changes and comparison with primary hip arthroplasty in the ADAPT cohort study. PLoS One. 2016;11:e0164839. - PMC - PubMed
    1. Vanhegan IS, Malik AK, Jayakumar P, Ul Islam S, Haddad FS. A financial analysis of revision hip arthroplasty: the economic burden in relation to the national tariff. Bone Joint J. 2012;94:619–623. - PubMed
    1. Hunt LP, Whitehouse MR, Beswick A, Porter ML, Howard P, Blom AW. Implications of introducing new technology: comparative survivorship modeling of metal-on-metal hip replacements and contemporary alternatives in the National Joint Registry. J Bone Joint Surg Am. 2018;100:189–196. - PubMed

Uncited Reference

    1. National Joint Registry for England, Wales. Northern Ireland and the Isle of Man Prostheses used in hip, knee, ankle, elbow and shoulder replacement procedures. 2016. http://www.njrreports.org.uk/Portals/0/PDFdownloads/NJR%2014th%20AR%20Pr... - PubMed
    1. Bayliss LE, Culliford D, Monk AP. The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study. Lancet. 2017;389:1424–1430. - PMC - PubMed