How long does a hip replacement last

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.

Evans JT, Evans JP, Walker RW, et al. Lancet (London, England) 2019 · PMID 30782340 · doi:10.1016/s0140-6736(18)31665-9

Question

What proportion of total hip replacements survive at 15, 20 and 25 years?

Design

Systematic review and meta-analysis of long-term case series and national joint registry reports.

Patients

Patients with primary total hip replacement and over 15 years of follow-up.

Intervention

Primary total hip replacement

Comparison

None (survival estimates)

Primary outcome

All-cause construct survival at long-term follow-up (up to 25 years)

Key result

Pooled registry data suggested that just under 60% of hip replacements last 25 years; case series reported higher survival than registries, which are considered less prone to bias.

Limitations

Includes implants and techniques that are now outdated, and revision as an endpoint underestimates failure in patients who are not revised.

Impact on practice

Provides the figures used when counselling patients about how long a hip replacement is likely to last.