This is one of the most difficult questions! The answer is of course, ‘it depends’. Many countries (including the UK) collect data on the outcome of hip replacement surgery. Surgeons complete a form after every operation detailing the indication for surgery, information about the patient and the implants used. Statistical analysis is performed on the data and this shows which implants last longest.

If we used this information in isolation when choosing the right implant for a particular patient, we would probably use something like a cemented Charnley stem and a cemented polyethylene cup. This hip replacement would almost certainly give excellent pain relief for most patients. However if you are under 65, have complex anatomy or want to do anything other than potter about, it might not fit the bill. The plastic socket will wear out in time, causing pain, instability and loosening of the implants. Joint replacement surgeons want to provide their patients with implants that will allow them to work, play some sports and return to as normal a life as possible. In order to this we use materials such as ceramics and chrome/cobalt/molybdenum which are durable and wear resistant. Hip replacements using thes materials haven’t been around for as long as the more traditional systems, and as a result they might at first glance might not appear to be as good as the older hips. However there is ample evidence in the literature to show that ‘conventional’ hip replacements in younger patients are more likely to fail in their lifetime than in older patients. Most of the joint replacement surgeons that I know spend a lot of time trying to work out which operations and implants are best for their patients. We use the information that is available to us to help inform our decisions, but ultimately rely on our training, experience and judgment to the do the best we can, as often as we can. If you want to find out which type of hip replacement might be best for you, speak to an experienced hip surgeon who will help you decide.