News release

From: The Lancet

The Lancet: Modern hip replacements nearly twice as likely to last 25 years compared to older implants, new study suggests

Modern hip replacements [1] are nearly twice as likely as older hip replacements [2] to last at least 25 years, suggests a new study published in The Lancet. The authors of the systematic review and meta-analysis employed advanced modeling techniques to estimate that 92% of modern hip replacements are likely to last at least 25 years. This represents a significant improvement compared to earlier studies on older hip replacement technologies, which indicated that approximately 58% of such implants could reach the 25-year mark.

Hip replacements are highly successful operations that help millions of people worldwide regain mobility and improve their quality of life. As more young patients undergo the procedure and people live longer, it is increasingly important to know how long these implants last. Over the past two decades, advances in the materials used for hip replacements have greatly reduced wear and may have improved their longevity. However, until now, there hasn’t been a large-scale study looking at how long these modern hip replacements truly last. The most recent major estimate, from a 2019 Lancet study [3], suggested that only about 58% of implants were still working after 25 years, but that analysis included older materials no longer in use, which were more likely to wear out or break.

The current study included data from eight national joint registries, covering nearly 1.9 million hip replacements, and clinical studies involving over 5,000 patients. The analysis found that around 93% of modern hip replacements last at least 20 years, and further modelling suggests that 91% could keep working well for at least 30 years. The authors highlight that while the results are reassuring at the population level, they don’t necessarily predict how long a hip replacement will last for each individual, with factors such as a person’s age, overall health, bone quality, and the surgical technique used all affecting outcomes.

The authors say their findings suggest that today’s hip replacements are lasting much longer, which can help doctors set clearer expectations for patients and guide future healthcare planning. For hospitals and health services, this could mean fewer people needing repeat operations, allowing specialist teams to focus on complex cases and helping more people get access to their first hip replacement.

[1] Modern hip replacements use more durable materials such as highly cross-linked polyethylene (XLPE) and newer types of ceramics, which became the standard treatment worldwide by 2008
[2] Older hip replacements used ultra-high-molecular-weight polyethylene (UHMWPE) for the hip socket or liner, which can wear and trigger inflammation, leading to bone loss and the implant loosening
[3] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31665-9/fulltext