Hip Replacement - How long will it last? Written by James Lewis, Sussex Hip Replacement Clinic

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SUSSEX HIP & KNEE REPLACEMENT CLINIC

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How long does “a hip last”? Improvements in hip replacement technology means that "at least 15 years" is a reasonable expectation for most patients. It does depends on your age, with younger patient's hip replacements on average, not lasting quite as long- see below. Taking a 70 year man for example:

97% of hip replacements will last 10 years in this age group Fast forward 15 years and 94% of the now 85 year old's hip replacements will be going strong. Remarkable really.

The image below (2020 data) shows all types of hip replacements bundled together to allow comparisons of the effect of age on redo rates over time - take a look at the 10 and 15 year timelines (dotted lines).

Years since the hip replacement

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SUSSEX HIP & KNEE REPLACEMENT CLINIC

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Does Age matter?

In younger people (see the colour bands for 5 year age groupings) the hips have a greater redo rate. This is in part because they will use it more in a given day / week. Furthermore they will be a bit younger 10 years down-the-line and thus may be more willing or wanting to undergo a redo than an elderly person.

Does the surgical technique matter?

You may spot that there is a rapid redo rate in the first year - about 1%. This isn’t because they have “worn out”. It may relate to an infection, or fracture or some technical aspect such as dislocation or leg length that has led to an early redo. Thus it is really important that the surgeon “gets it right” first time, and of course minimises the risk of infection. Attention to detail is everything. A stable and brilliant team is essential. Mr Lewis is pleased to say that he hasn't haven’t had an infection in a hip replacement for 10 years (National Joint Registry Data). Mr Lewis was fortunate to have been well trained and he is obsessed with the detail of infection prevention.

Better implants give better results

Better implants and the best bearing surfaces are 1-2 percent better at 10 years in terms of avoiding revision surgery (redo) than these average figures, the reverse is also true. For example a ceramic ball on a highlycross-linked-polyethylene socket has a 1.57% higher survivorship rate (absence of redo) than a metal ball on the same socket at 13 years (2020 Registry report). The ceramic socket liners haven’t stood up to the expectations from wear simulators and thus are used less and less.

CUSTOM KNEE REPLACEMENT • RAPID RECOVERY • HAMMER FREE KNEE REPLACEMENT • MUSCLE PRESERVING HIP REPLACEMENT


SUSSEX HIP & KNEE REPLACEMENT CLINIC

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Better Hospitals

Each dot represents a hospital. The green line is the average redo rate for hip replacements, the red lines are the spread around that green line. Goring has a very, very, low redo rate for hip replacements. From the National Joint Registry we know which hospitals have low redo rates. At Goring Hall we are pleased to have brilliantly low redo rates compared to other Hospitals in the country (2020 National Joint registry report). This allows you to select better Hospitals for your hip replacement.

Current Hip replacements are better than older ones.

Please note that the 10 year data is from hip replacements put in 10 years ago. The implant materials have improved since then and we have better knowledge of which the best implants are and the ones to avoid. So expectations of how long a hip will last that is put in NOW are better than what we are observing of hip replacements put in way back.

National Joint Registry analysis confirms they are! has• MUSCLE CUSTOM KNEE REPLACEMENT • RAPID RECOVERY • HAMMER FREE KNEE REPLACEMENT PRESERVINGregarding HIP REPLACEMENT avoid. Also our technical understanding improved


SUSSEX HIP & KNEE REPLACEMENT CLINIC

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Mr Lewis's Hip replacement components The Socket: A titanium hemisphere with or without bone mineral coating called Hyydoxyapatite. The component is called Pinnacle. The Liner: A highly cross-linked polyethlene termed Altrx,- this is very low friction, ultra low wear, inert and doesn't squeak! The Ball: A delta ceramic(pink made by Ceramtec, this is hard, smooth and highly polished. Mr Lewis uses a 32mm or 36mm depending on patient frame size. The 15 year results are over 97% are in place! Wow.. The Stem: A titanium stem, titanium is a metal that is slightly flexible, thus is able to bend in a manner more similar to bone than other stiffer metals. It also is bone friendly for bone ingrowth. It is fully coated with bone minerals, synthetically made to provide ready raw materials for bone ingrowth. It is called Corail and is the No 1 stem in the UK as chosen by surgeons.. It has a great 220 year track-ck record. These - uncemented stems - also have a lower infection rate than their cemented brothers.

CUSTOM KNEE REPLACEMENT • RAPID RECOVERY • HAMMER FREE KNEE REPLACEMENT • MUSCLE PRESERVING HIP REPLACEMENT


SUSSEX HIP & KNEE REPLACEMENT CLINIC 0345 912 1000

How long does it last? Data for a un-cemented with a ceramic on polyethylene bearing. 97.5% last 10 years with no noticeable change to 15 years.

If you would like to talk about Hip replacement please ring Deborah on 0345 912 1000

Or simply request a consultation here: Self referral form:

James Lewis 5th March 2021. Data is from 2020 National Joint Registry report.

CUSTOM KNEE REPLACEMENT • RAPID RECOVERY • HAMMER FREE KNEE REPLACEMENT • MUSCLE PRESERVING HIP REPLACEMENT


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