Using a systematic review and meta-analysis of case series and cohort studies, researchers from the UK have reported that just over half of all hip implants last at least 25 years.
The study, “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,” appears in the February 16, 2019 edition of The Lancet.
To do the review, the authors identified 140 eligible articles reporting 150 series. They focused on 44 of these series which represented 13, 212 total hip placements. The authors also checked the national joint replacement registries from Australia and Finland and collected data for another 92 series representing 215,676 total hip replacements.
Co-author Jonathan T. Evans, M.R.C.S., a clinical research fellow at the University of Bristol in the UK, explained the main driver behind the study to OTW, “The main driver to complete the research was the fact that patients regularly ask us how long hip or knee replacements last and it was very hard to give them a clear answer.”
“We knew there were many sources of information out there and with so many types of hip and knee replacements available, we recognized it could be quite confusing for a patient who wanted to know the answer. We set out therefore, to try and provide a simple answer that applied to as many patients as possible.”
“We found that, according to registry data, just over half of hip replacements last 25 years,” wrote the authors. “Published case series suggest better survivorship at 20 years and 25 years. The data from the two sources are similar at 15 years. Concordance at 15 years is encouraging, but the differences at 20 and 25 years suggest that the two types of data probably have different sources of bias.”
Jonathan T. Evans commented to OTW, “We were surprised by how well both hip and knee replacements lasted with a higher proportion still in situ at 25 years than we estimated. We feel this is great news for patients and allows them to go into surgery with confidence, knowing what they can expect.”
“The main aim for this study is to provide patients with clearer information on what to expect. The decision of when to operate will always remain a decision between each individual patient, their family and their surgeon; but hopefully this research will help guide those discussions. We foresee the main use of the results to be in the consent process as well as the pre-operative decision making.”
