How Long Does a Total Hip Last?
The general advice about total hip replacement is that the artificial hips can last about ten years before needing revision. However, improved methods may make that advice somewhat obsolete, even for younger patients. Two recent scientific studies give a more optimistic outlook about the durability of total hip replacement.
Most total hips consist of a metal ball on a stem that inserts into the upper end of the thigh bone (femur), and a socket, or cup, made of plastic material called polyethylene. (learn more: https://hipdysplasia.org/adults/total-hip-replacement/) Approximately 20 years ago a new type of polyethylene socket was introduced. This new plastic is called “Highly Cross-Linked Polyethylene” while the original material is called “Conventional Polyethylene”. The newer polyethylene is strengthened by using electron beams to increase the cross-linking, and followed by re-melting to further strengthen the plastic and to eliminate free radicals that can interfere with bone health. This Highly Cross-Linked Polyethylene is stronger and has lower likelihood of causing loosening of the cup as the years go by.
Over the last fifteen years, the newer polyethylene has significantly decreased the loosening and revision rates even for younger, more active patients. [https://pubmed.ncbi.nlm.nih.gov/33411465/]
Another study has also shown increased durability of total hips performed since the introduction of this new type of polyethylene. This study only looked at total hips performed after the age of 45 years. As expected, the authors found that total hip replacements last longer in older patients, presumably because of less vigorous activities. However, the results in patients between the age of forty-five and sixty were remarkably encouraging. After ten years, only 10% of patients had required revision surgery. This means that nine out of ten people were still going strong on their original hip replacement. The authors further estimated that three out of four patients age 45 to 60 would never require additional surgery for their original total hip replacement.
This means that doctors may need to revise their advice about how long a total hip can last. The improved quality of total hips is a major reason why artificial replacement is often recommended for hip dysplasia after the age of 45 years instead of hip preservation surgery with a PAO. Even for younger, active patients, the number of total hip replacements is increasing because the newer methods are more reliable and less likely to break down in ten years.