Patients undergoing total hip replacement (THR) often require further orthopaedic surgery including other primary lower limb joint replacements and revision surgery in their lifetime. We analysed the 10-year data of 552 patients who underwent primary total hip replacement between April 1991 and March 1992 at our institute. Data was available for all patients before the index operation. 77% of patients attended their 5-year review and 67% attended their 10-year review. 233 (42%) had had or subsequently had the opposite hip replaced. 30 patients (5%) had a knee replaced and 19 (3%) had both knees replaced. 4.4% underwent revision surgery.

Concluding, nearly half the total number of these patients will in due course require the opposite hip replaced. 13% will need another major joint surgery (ie revision or TKR). At £6138 for a primary THR and £8500 for revision THR, and the cost of radiographs (£60) and follow-up appointment (£60), the approximate cost implications on a conservative estimate are 13 million pounds. For a single surgeon undertaking 40 THRs in a single year the cost would be approximately £900,000. In addition, the surgeon in 10 years practice would create enough work to last him the rest of his working lifetime. These factors including cost implications and human resource requirements will have significant influence on future planning of health care trusts.