Knee and hip replacements and the risk of revision

As Jonathan Evans and colleagues

report, survivorship of total hip replacement was 85·7% (95% CI 85·0–86·5) at 15 years, 78·8% (77·8–79·9) at 20 years, and 77·6% (76·0–79·2) at 25 years in the case series, and 89·4% (89·2–89·6) at 15 years, 70·2% (69·7–70·7) at 20 years, and 57·9% (57·1–58·7) at 25 years derived from registry data. The data answered a question asked by nearly all patients who come to our outpatient department for total hip replacement.

However, we find that no Chinese studies have been included, which might confound generalisability because different patient populations can have different survivorship. Although our medical centre published several long-term follow-up studies after total hip replacement,

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the average follow-up was less than 15 years. One of our studies,

in which the average follow-up time was more than 15 years, was excluded because the article was written in Chinese.

Approximately 400 000 primary total hip replacements were done in China in 2015, a number that has been increasing 25–30% per year.

With more and more total hip arthroplasty done in China, we are establishing a national joint registry in China. I hope that our future follow-up study could provide a reference for long-term survivorship among Chinese patients. Additionally, we hope that China’s national joint registry will be established as soon as possible and provides more high-quality data regarding total joint replacement in the future.

We declare no competing interests.