The National Joint Registry holds data on more than 1.6 million cases of joint replacement, which it has been collecting since 2003. Recent data* have shown that 90 day mortality rates after hip replacement fell from 0.56% in 2003 to 0.29% in 2011 and that 45 day mortality rates after knee replacement fell from 0.37% to 0.2% over the same period. The number of hip joint replacements has increased over this time.
They also showed that 10 year revision rates for hip and knee replacement procedures were now less than 5%, although the rates varied according to age (with younger patients more likely to need an implant replaced), the type of implant, and the type of operation.
It is thought that fitter patients and also improved physiotherapy could be reasons for this reduction in mortality. In addition, the use of spinal anesthetics is associated with a reduction in complications. Interestingly, patients who are overweight (with a BMI of 25-30) had a lower risk of death after hip surgery than those with a normal BMI of 25-30. Elderly men seem to be most at risk of death following hip replacement surgery.
Another audit, from the National Hip Fracture Database, looked at the care given to over 64 000 hip fracture patients in England, Wales, and Northern Ireland in 2013. It found that the average 30 day mortality in has also reduced; resulting in 300 fewer people dying within 30 days of hip fracture in 2013 than in 2011-12.
As I have recently found out that my mother needs a hip joint replacement, I find these figures very reassuring and encouraging!
* Kmietowicz Z. Mortality after hip and knee replacement has halved since 2003. Published 12 September 2003. BMJ 2014;349:g5599.