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At least 35

This is the answer to the question of how many hip replacements a surgeon should undertake a year.

Each year approximately a million hip replacements are performed each year. Outcomes are generally excellent with over 95% of hips surviving for at least 10 years.

Unfortunately complications do occur including infection, bone fracture, loosening, death and dislocation. Complications can be affected by patient, implant and surgeon factors.

The operation is technically demanding and takes a long time to learn to perform correctly.

A recent study has shown that the risk of dislocation increase in surgeons undertaking less than 35 hip replacements a year, or 3 a month. The risk of the joint dislocating continues to rise as the number of operations performed falls.

Reduced surgical volume was not associated with an increased risk of death, infection, fracture or blood clots.

Dislocations tend to occur shortly after a hip replacement. It is unclear whether a low surgical volume is related to long term complication rates, but this may be the case.

Most surgeons may not know the exact number of replacements they perform each year, but will know if they are above or below 35. Do not be afraid to ask.