Last updated: 11/24/2009

The demographics of hip revision surgery are likely to change significantly over the next few decades as the proportion of people over 65 in the world's population continues to increase. As of 2003, however, demographic information about this procedure...

is difficult to evaluate. This difficulty is due in part to the fact that total hip replacement (THR) itself is a relatively new procedure dating back only to the early 1960s. Since the design of hip prostheses and the materials used in their manufacture have changed over the last forty years, it is difficult to predict whether prostheses implanted in 2003 will last longer than those used in the past, and if so, whether improved durability will affect the need for revision surgery. On the other hand, more THRs are being performed in younger patients who are more likely to wear out their hip prostheses relatively quickly because they are more active and living longer than the previous generation of THR recipients. In addition, recent improvements in surgical technique as well as in prosthesis design have made hip revision surgery a less risky procedure than it was even a decade ago. One Scottish surgeon has reported performing as many as four hip revisions on selected patients, with highly successful outcomes. According to one estimate, 32,000 revision total hip arthroplasties were performed in the United States in 2000.

While information on the epidemiology of both THR and hip revision surgery is limited, one study of Medicare patients in the United States who had had either THR or revision hip surgery between 1995 and 1996 was published in January 2003. The authors found that three to six times as many THRs were performed as revision surgeries. Women had higher rates of both procedures than men, and Caucasians had higher rates than African Americans. Other researchers have reported that one reason for the lower rate of hip replacement and revision procedures among African Americans is the difference in social networks. African Americans are less likely than Caucasians to know someone who has had hip surgery, and they are therefore less likely to consider it as a treatment option.