Independent, sourced patient educationInformedSurgery
Hip Replacement Explained
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All topics
  1. What it is
  2. Who it helps
  3. Timing
  4. The procedure
  5. What a hemiarthroplasty is
  6. Hemi vs total hip
  7. Recovery after hip fracture
  8. Patient journey
  9. Recovery supplies
  10. Finding a surgeon
  11. Insurance and costs
  12. Questions to ask
  13. Implant designs
  14. Side-by-side
  15. Robotics and navigation
  16. US manufacturers
  17. What the evidence says
  18. Value analysis
  19. Resources
  20. Glossary
  21. References

Overview

Timing: when is the right time?

For planned (elective) hip replacement, timing is usually your decision, made with your surgeon. The right time is generally when the hip limits the life you want to live and other treatments no longer help enough.46

Age matters for how long the implant needs to last

Modern hip replacements are durable. In a large UK cohort, about 96% were still in place at 10 years and about 85% at 20 years.7 Pooled national registry data suggest about 58% last 25 years.6 Because younger people live longer and are more active, they have a higher lifetime chance of needing a second operation (a revision).7 That's a reason to think carefully, not a reason to suffer indefinitely.

Waiting too long has costs too

Severe pain and limited walking lead to weaker muscles and less fitness, which can make recovery harder. Getting stronger before surgery, whenever it happens, helps.46 See preparing for hip replacement.

A broken hip is different

When an older adult breaks a hip, surgery is usually urgent, often within a day or two of reaching the hospital, and the choice between a total hip and a hemiarthroplasty depends on the fracture and the person's health and activity.49 See hip fracture and hemiarthroplasty.

Clinical detail
  • UK CPRD cohort (63,158 THAs): 10-year implant survival 95.6%, 20-year 85.0%. Median time to revision for patients operated on before age 60 was 4.4 years.7
  • 25-year pooled survival: 57.9% in national registries (Australia, Finland) vs 77.6% in published case series, which are more prone to bias.6

Sources for this page

  1. Evans JT, et al. 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. Lancet. 2019;393(10172):647-654. doi:10.1016/S0140-6736(18)31665-9
  2. Bayliss LE, et al. 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(10077):1424-1430. doi:10.1016/S0140-6736(17)30059-4
  3. American Academy of Orthopaedic Surgeons, OrthoInfo. Total hip replacement. orthoinfo.org/bodypart/hip-thigh/total-hip-replacement
  4. American Academy of Orthopaedic Surgeons. Management of hip fractures in older adults: evidence-based clinical practice guideline (December 3, 2021). aaos.org/hipfxcpg

All references