Revision hip and knee replacement volumes projected to climb by 2060

Design

Registry-based modelling study, capped Poisson model with sensitivity analyses

Population

17 countries with national joint registries; adults 25 and older

Primary outcome

Projected annual revision hip and knee arthroplasty volumes to 2060

Effect

Revision hip +31%, revision knee +41% vs 2024 (aggregate +36%) under the primary model

Using a uniform model across 17 registry-equipped countries, this analysis projected annual revision hip and knee arthroplasty volumes to 2060. In 2024 the modelled aggregate was about 186,000 revision hip and 190,000 revision knee procedures; by 2060 these reach roughly 243,000 and 267,000 — increases of 31% and 41%, or about a third overall.

The growth is uneven. The United States and China account for most of the absolute increase, while Germany, the United Kingdom and Sweden approach plateaus by mid-century and Japan is projected to decline. Sensitivity analyses bracketed the 2060 combined total between roughly 461,000 and 511,000 procedures.

This is a planning signal rather than a bedside finding. A rising revision burden has direct implications for revision-surgery training pipelines, perioperative infection-prevention programmes, and the registry infrastructure needed to track outcomes — relevant to any system, including India's, expanding its primary arthroplasty volume now.

• Projection across 17 registry countries that perform most of the world's hip and knee replacements.
• Revision hip arthroplasty up about 31% and revision knee about 41% by 2060, roughly a third overall.
• The United States and China drive most absolute growth; mature European systems plateau and Japan declines.
• Expanding primary arthroplasty now means planning revision capacity and infection prevention for later.
• This is a modelling projection (prognostic level IV), not an observed trend.

Why it matters

It turns the known growth in primary joint replacement into a concrete future workload that services have to resource before it arrives.

Don't overread it

This is a statistical projection to 2060; actual volumes depend on implant survival, practice change and demographics that the model can only approximate.

The statistics, in plain English

These are modelled projections, not counts: the four methods spanned roughly 461,000 to 511,000 combined procedures in 2060, so the direction is robust but the exact figures carry real uncertainty.

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