- Design
- Registry-based Poisson projection model with sensitivity analyses
- Population
- Revision hip and knee arthroplasty volumes in 17 registry countries
- Primary outcome
- Projected annual revision volume in 2060
- Effect
- Revision hips +31% (243,404); revision knees +41% (267,456) vs 2024
Using registry reports from 17 countries that perform most of the world's joint replacements (JBJS, 30 September 2026), investigators applied one uniform Poisson model, with growth capped and damped, to project revision volumes from 2024 to 2060.
The 2024 aggregate was about 186,000 revision hips and 190,000 revision knees. By 2060 the primary model projected 243,000 and 267,000, rises of 31% and 41%. The United States and China accounted for most of the absolute growth; Germany, the UK and Sweden approached a plateau, and Japan declined. Sensitivity analyses put combined 2060 volume between about 461,000 and 511,000.
These are model projections, not observations, and India was not among the countries modelled. Still, the direction is clear for any health system with a growing primary arthroplasty volume: revision capacity, infection prevention and registry data need planning now.
- Plan revision capacity and training for a rising caseload, especially for knees.
- Invest in infection prevention, since infection is a leading cause of revision.
- Support national joint registries; these projections depend on them.
- Indian figures were not modelled, but a fast-growing primary volume implies a similar trajectory.
Why it matters
Today's primary replacements are tomorrow's revisions, and health systems that have not planned for them will meet them as waiting lists.
Don't overread it
These are model-based projections with assumptions about future trends, not observed counts.
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