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Long-term Outcomes of Hip Replacement

Information for healthcare professionals

Although THR is a highly successful procedure in many patients, younger patients are more likely to require revision surgery in the early years after their primary surgery than older patients (Figures 4-5). The rate of revisions beyond 10 years also increases in younger patient groups (the graphs become steeper), illustrating the number of younger patients who will face a more complex and expensive revision operation in their lifetime.

Figure 4

Figure 4: NJR Kaplan-Meier estimates of cumulative revision of all hip replacements, excluding MoM THR and resurfacings5.
Note the increasing rate of revisions (upward curve) for younger patients beyond 10 years.

Figure 5

Figure 5: Swedish registry survivorship of total hip replacements for younger patients: 30-50% of patients will have required
revision surgery within 25 years of their primary operation24

Registry data does differ for individual devices and bearing options; however, a distinct overall trend is evident in younger males for whom hip resurfacing is most often prescribed (80.6% of the AOANJRR-recorded hip resurfacing patients were male with average age 53.4 years, SD: 9.1)19. An independent post-market surveillance report on ADEPT® Hip Resurfacing25 found that male patients under the age of 50 with indication osteoarthritis have a lower risk of revision than any THR bearing type: 0.9% (0.0, 1.9) at 10.5 years. Not only have these patients benefitted from the return to activity offered by hip resurfacing, but they have also become less likely to have required a revision surgery than similarly aged THR patients overall.

Young, male hip resurfacing patients are less likely to require revision surgery than similarly aged THR patients.



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Factors Influencing Survival

Appropriate device design is an essential factor for the performance of a hip resurfacing device. Different metallurgy, clearance, geometry and fixation are proven to affect clinical outcome and, consequently, results have differed greatly between devices.