Hip Replacement Lifespan: What the Experts and Studies Reveal

What is the average lifespan of a total hip replacement?

To determine how long a hip replacement lasts, I don’t rely solely on my experience as a physical therapist.

Even though I have supervised dozens of hip replacement rehabilitations, I don’t see these patients long-term. More importantly, there are studies that follow patients for several decades after their surgery.

These are therefore the clinical study data I rely on!

Here are the most reliable and recent data I’ve found on this topic:

6 out of 10 people who received a total hip replacement for osteoarthritis keep their prosthesis for more than 25 years.

Lancet 2019

These figures are based on the follow-up of over 13,000 people who underwent total hip replacement in 16 different countries.

However, there are other reasons for surgical revision of a hip replacement besides simple “wear” [Nugent 2021]. The four main reasons are:

• Aseptic loosening, often due to poor positioning of the replacement,
• Infection,
• A femur fracture around the replacement,
• Dislocation of the hip replacement.

Therefore, the 6 out of 10 re-operations are not necessarily due to wear of the prosthesis, but also potentially for these other causes, especially since these are the most common reasons for re-operating on the hip.

What is the average lifespan of a partial hip replacement?

We do not have much data on the specific lifespan of partial hip replacements.

The limited data available suggest that the lifespan of a partial hip replacement is similar to that of a total hip replacement [Edelstein 2023].

Therefore, it is likely that around 6 out of 10 people who undergo a partial hip replacement keep their prosthesis for more than 25 years.

What is the lifespan of a ceramic hip replacement?

Ceramic is one of the most commonly used materials for hip replacements.

There are several possible combinations of materials:

• Ceramic/ceramic
• Metal/polyethylene
• Metal/metal, etc.

Often, patients are unaware of the materials used in their prosthesis.

The main study evaluating the lifespan of a total hip replacement [Lancet 2019] does not consider the material of the prosthesis.

Therefore, it is reasonable to assume that 6 out of 10 people with a ceramic total hip replacement have a prosthesis lifespan of more than 25 years.

Some studies attempt to determine if the risk of surgical revision is lower (or higher) with a ceramic prosthesis compared to other materials [Example: Madanat 2018].

But the data do not allow for definitive conclusions due to many uncontrollable factors.

What factors influence the lifespan of a hip replacement?

Identifying the factors that influence the risk of hip re-operation after a replacement is challenging.

Here are the factors with the most evidence in the international scientific literature, focusing only on modifiable factors that can be influenced at the individual level.

The Later You Have Surgery, The Less Likely You Are to Need Another Operation

This seems logical: people who get a hip replacement at 90 are much less likely to need another surgery than those who get one at 45.

Here are some precise data on this [Nugent 2021]:

• Among those aged 46-50 at the time of their hip replacement, just over 1/4 will need another surgery in their lifetime.
• This risk decreases with age.
• Among those aged 90-95 at the time of surgery, just over 1/100 will need another surgery in their lifetime.

How to Tell if a Hip Replacement is Worn Out

Some people have had a hip replacement for more than 25 years without any significant discomfort or pain: great!

Even if you’ve had your hip replacement for a long time, if you don’t have any discomfort or pain, there’s no need to worry.

However, hip pain remains relatively common after hip replacement surgery.

Experiencing hip pain is not enough to suggest that the prosthesis is damaged, especially if the pain occurs within the first 10 years.

Detecting a Worn Hip Replacement

There are no highly characteristic clinical signs that indicate your prosthesis is worn out. Only imaging tests can confirm wear, after an initial assessment by a doctor to determine if such tests are necessary.

What to Do if You Think Your Prosthesis is Too Worn?

If you’ve had increasing pain and discomfort in your hip with a replacement for several years, you can discuss it with:

• Your general practitioner
• Your physiotherapist
• Another trusted doctor (e.g., sports medicine doctor, rheumatologist)

Your healthcare professional will ask questions, examine you, and may refer you to other specialists (orthopedic surgeon) or for additional tests (X-ray, MRI).

They may also reassure you if the issue is minor and temporary.