Short: How Long Does a Replaced Hip Survive and Why it Matters
Hip replacements (THRs) are game changing if you have a bad hip and can potentially improve healthspan and lifespan even more, considering that more than 90% of modern THRs have a survival now of up to 30 years.
The Short Series
This is a new series that looks at interesting, new research and data that may not necessarily lead to any addition or subtraction to the 15-point guideline, but are issues worth knowing about or understanding from a larger healthspan/lifespan perspective.
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Bhavin Jankharia
The Detailed 15-Point Guide to Live Long, Healthy
Bhavin Jankharia
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Surgical procedures have played a major role in the development of modern medicine. Advances in anesthesiology and in surgical techniques have changed the landscape of medicine. While preventive surgeries in otherwise normal people (e.g. gall bladder surgery for a gallstone to prevent a future problem) can create ethical minefields, in people who are ill and diseased, surgical procedures when done appropriately and well, potentially increase an individual’s healthspan and lifespan.
Bhavin Jankharia
There are many surgeries that are pivotol, of which the relevant ones for us in our quest to live long healthy would be...
A. Sensory/Cognitive
1. Cataract surgery - this changes a person’s life, especially if they are living with poor vision and if done in time, would prevent vision loss, directly impacting healthspan and lifespan, preventing falls, cognitive loss and all the other issues related with poor vision when old.
Bhavin Jankharia
B. Mobility
2. Knee and hip replacements - in patients with hip and knee joint issues, especially degenerative disease or osteoarthritis (OA), these procedures are life-changing.
C. Life-Extending
3. CABG (coronary artery bypass grafts) and percutaneous coronary interventions (PCI - stents, valve replacement, etc) - in the correct clinical context, especially during acute events or when the symptoms affect the ability to lead a normal life, make a difference.
4. Oncology surgery - all forms of cancer removal surgery.
5. Transplant surgery - kidney being the commonest and then others.
One common procedure that has been around for many decades is total hip replacement. This is typically done when the joint is affected and can no longer function normally and a person is disabled or has to walk with a limp or crutches or is in severe pain. The commonest cause is accelerated age-related degeneration, though prior injury, infection and inflammation can lead to premature osteoarthritis (OA). It is also done as a primary procedure for acute femoral neck fractures, where ideally the surgery should be done in under 24 hours for the best long-term outcomes.
Bhavin Jankharia
Hip replacement is a reasonably standard procedure, which for many years has had an implant survival span of around 15 years. Which meant that if you had a THR (total hip replacement) done at age 60, it was possible that you would need a revision by age 75. Revision surgeries are more difficult and lead to more complications and if we could avoid doing them, that would be ideal. Deferring THRs until you are older is logical, but that has its own opportunity cost of living with pain, poor mobility, inability to be physically active and all the cascading issues that would reduce healthspan and lifespan.
A recent Lancet study [1] has addressed this issue by looking at over 1.9 million THRs across 29 clinical studies over 30-years. This study headed by Veronica Pentland shows that there is a 92% 30-year survival of contemporary or modern THRs mainly due to advances in polyethylene and ceramic technology, which reduce wear and tear and increase the long-term durability of the implants.
This potentially changes the game, because now you can think in terms of a 30-years horizon and get THRs done earlier or perhaps just whenever you need them.
What does this mean for you and me. If you or anyone you know is disabled because of hip issues and is considering the possibility of a THR, then it is good to know that THRs now are likely to last for at least 30 years, which would allow better decision making about when to get a THR done.
Footnotes
1. Pentland V, Thompson Z, Dayimu A, Demiris N, Bohm E, Campbell D, et al. Survivorship of modern total hip replacement to 30 years: systematic review, meta-analysis, and extrapolation of global joint registry data. The Lancet. 2026 Feb;407(10531):855–66. doi:10.1016/S0140-6736(25)02305-0
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