What Is the Average Age for Hip Replacement?

Most people who receive a hip replacement are in their late 60s. A large population-based study of more than 67,000 patients found the median age at the time of surgery was 68, though this varied by sex: women had a median age of 69, while men came in at 66.¹ That number represents a broad middle ground, though, and the reality is more interesting than a single figure suggests. The age at which people actually end up on the operating table depends on body weight, sex, underlying diagnosis, and even where in the world they live.

How the Typical Patient Age Has Shifted Over Time

Hip replacement used to be thought of as a procedure for the elderly. That perception is outdated. Across developed countries, the fastest-growing group of hip replacement recipients has been people under 65. An analysis of utilization trends across OECD countries found a sevenfold higher growth rate among patients aged 64 and younger compared with older patients.² The procedure is increasingly being performed in younger adults who want to stay active and mobile rather than waiting until disability becomes severe.

At the same time, one single-center study tracking hip replacement patients over a recent decade found the opposite trend at the institutional level: patient age actually rose from about 62 in 2013 to about 65 in 2022, alongside increases in body mass index and the number of other health conditions patients had at the time of surgery.³ These two findings are not necessarily contradictory. The global picture reflects more people getting hip replacements overall, with younger patients entering the pool in large numbers. But at any individual hospital, the average age can rise if an aging population brings more older patients through the door simultaneously. The takeaway: the “typical” age is not a fixed number, and it has been in motion for decades.

Why Women Tend to Be Older at Surgery

Across most registry data, women undergo hip replacement at slightly older ages than men. UK data from 1991 through 2006 showed that the mean age at operation was consistently higher for women than for men, and this gap stayed stable over the entire study period.⁴ More recent population data confirmed this pattern, with a median age of 69 for women versus 66 for men.¹

Part of this likely reflects patterns of osteoarthritis, the most common reason for hip replacement. Women develop symptomatic hip osteoarthritis later in life on average, often accelerating after menopause. But there is also evidence of referral bias: studies in the UK have found that women, along with patients of lower socioeconomic status and certain ethnic minorities, face more barriers to accessing surgery in a timely way.⁵ Whether the age gap is entirely biological or partly a product of healthcare access is still debated.

Body Weight Pulls the Average Age Down Significantly

One of the strongest predictors of getting a hip replacement at a younger age is being significantly overweight. Patients with a BMI of 35 or higher underwent hip replacement roughly seven years earlier than patients with a normal BMI.⁶ A separate study found the gap was even wider for the most severely obese patients: those classified as morbidly obese had their hip replaced about ten years earlier than normal-weight patients on average.⁷

This makes intuitive sense. Excess weight accelerates cartilage breakdown in weight-bearing joints like the hip. It also contributes to chronic inflammation that damages joint tissue beyond what mechanical loading alone would cause. If you are carrying substantially more weight, the timeline to a worn-out hip compresses.

Getting a Hip Replacement Young Means Facing Revision Later

For someone in their 50s considering a hip replacement, the central concern is not whether the surgery will work now but whether the implant will last long enough to avoid a second surgery. Revision surgery, where the original implant is removed and replaced, is more complex, carries higher complication rates, and tends to produce somewhat less favorable outcomes than the first procedure.

A large population-based study estimated that a man who receives a hip replacement between the ages of 50 and 54 faces a roughly 30% lifetime risk of needing revision surgery.⁸ For women in the same age range, the risk was about 15 percentage points lower. A separate registry analysis placed the lifetime revision risk at about 28% for patients aged 46 to 50, declining steadily with age to just over 1% for those operated on at 90 or older.⁹ By age 70, which approximates the average age of implantation, the lifetime revision risk dropped to somewhere between about 4% and 8%.⁸

These numbers explain the historical reluctance to operate on younger patients. If you get a hip replacement at 52 and live to 82, you are asking a mechanical device to function under load for three decades. The younger and more active you are, the more wear the implant accumulates.

Modern Implants Are Lasting Longer Than Expected

The good news for younger patients is that implant durability has improved substantially. A 2019 meta-analysis combining data from case series and national registries found that about 86% of total hip replacements survived at least 15 years, roughly 79% made it to 20 years, and about 78% lasted to 25 years based on case-series data.¹⁰ Those numbers were reassuring, but they included older implant designs and bearing surfaces.

A more recent systematic review focused specifically on modern implant designs and found dramatically better results. Using global joint registry data, it estimated survivorship of about 94% at 20 years and projected that roughly 92% of modern implants would still be functioning at 30 years.¹¹ That is a major leap forward. For a 55-year-old receiving a hip replacement today, a 30-year implant lifespan would carry them into their mid-80s, potentially without ever needing revision. This shift in implant performance is one of the reasons surgeons have become more willing to operate on younger patients.

What Happens When Older Patients Have Surgery

At the other end of the spectrum, hip replacement in patients over 80 carries a different set of risks. Older patients have higher rates of in-hospital complications, and the likelihood of complications rises progressively with advancing age. ICU use and the chance of being discharged to a nursing facility rather than home also increase.¹² A study specifically looking at patients in their 80s and 90s undergoing hip replacement confirmed that complication and readmission rates were notably higher in this group.¹³

But higher risk does not mean the surgery is not worthwhile. A review of 100 consecutive elective hip replacements in patients in their 80s (average age about 83) found that 92 of the 100 returned home after the operation. Major complications occurred in 8% of cases. The preoperative health rating of each patient was a strong predictor: those who were otherwise healthy had a 0% rate of major complications, while those with significant other health conditions had a 15% rate. Among patients followed for more than two years, 49 out of 52 said they were glad they had the operation.¹⁴ More recent data reinforced this picture: satisfaction rates after hip replacement in patients aged 80 and older did not differ meaningfully from those in a 65-to-75 age group, even though the older patients showed slightly less improvement on functional scores.¹⁵

The critical distinction for older patients is between elective and emergency hip surgery. A hip replacement planned in advance for osteoarthritis is a fundamentally different undertaking from an emergency operation after a hip fracture. Compared to elective replacements, hip fracture surgery carries roughly six times the risk of dying before hospital discharge and about two and a half times the risk of major complications, even after accounting for differences in patient health.¹⁶ This gap matters for older patients considering whether to go ahead with elective surgery: the planned procedure done while someone is otherwise healthy is much safer than the emergency surgery forced by a fracture later.

Hip Fracture Patients Are a Different Population

When people talk about “the average age for hip replacement,” they usually mean elective total hip replacement for arthritis. But a substantial number of hip replacements are performed after a hip fracture, and these patients tend to be considerably older, frailer, and sicker. A matched comparison found that fracture patients had a 30-day mortality rate of about 1.8%, versus 0.3% for elective patients, along with higher rates of reoperation and readmission.¹⁷ The hip fracture group also had longer hospital stays and were far less likely to be discharged to their own homes.

This distinction matters because when statistics lump all hip replacements together, the fracture population pulls complication rates upward and can make the overall picture look grimmer than it is for someone considering a planned, elective replacement. If you are researching outcomes, make sure the numbers you are reading apply to elective surgery rather than to the fracture population.

Returning to Work and Activity

For younger patients, a practical question looms just as large as implant survival: how quickly can you get back to your job? A nationwide cohort study from Finland found that 94% of working-age patients returned to work after hip replacement, taking an average of about 103 days.¹⁸ People in desk jobs returned considerably faster than those in physically demanding work. Being obese also slowed the return to work.

A broader meta-analysis that pooled data from multiple studies put the overall return-to-work rate at about 70% across all populations, with a mean time of roughly 11 weeks. By two years after surgery, the rate climbed to about 90%. Older age and heavy manual labor were the strongest predictors of not returning to work at all.¹⁹ These numbers help explain why surgeons now take a more individualized approach to timing: a 50-year-old office worker facing years of pain and immobility may benefit more from early surgery than from waiting until a conventional age threshold.

Does Waiting Too Long Cost You Quality of Life?

There is a real cost to delaying surgery beyond the point where it would be beneficial. A health-economic modeling study examined what happens when hip replacement is deferred in patients who are already good candidates. For a 55-year-old woman, timely surgery was associated with roughly 20.7 quality-adjusted life years going forward, compared to about 16.7 if surgery was delayed by a median of 11 years. Even medical management alone, without surgery at all, yielded only about 10.3 quality-adjusted life years. The incremental cost to the healthcare system of doing timely surgery versus delaying it was modest.²⁰ In other words, making someone wait years for a hip replacement when they already need one is neither cheap nor kind.

That said, “timely” does not mean “as early as possible.” Surgeons weigh the severity of symptoms, the degree of joint damage on imaging, the patient’s response to conservative treatments like physical therapy and anti-inflammatory medications, and the patient’s overall health before recommending surgery. The decision is about matching the right timing to the right patient, not hitting a particular birthday.

Younger Patients Want Different Things From Surgery

One of the more overlooked aspects of age and hip replacement is that younger and older patients define success differently. When researchers interviewed hip replacement patients under 50, they found that these patients’ concept of “function” was not really about range of motion or walking ability, as it tends to be for older patients. Instead, younger patients talked about functioning at work, fulfilling roles in their families, and participating in social life. Many of these concerns were not well addressed by standard care pathways designed around an older population.²¹

In terms of measurable outcomes, younger patients under 55 actually reported worse pain, function, and quality of life before surgery than older groups. After surgery, they achieved bigger improvements in pain and function. But the absolute difference between age groups at one year was small enough that it did not cross the threshold for being clinically meaningful.²² Satisfaction among younger adults who had their expectations met was high, though about one in five reported that the surgery did not fully meet their expectations.²³ Going into surgery with realistic goals and having a frank conversation with your surgeon about what the hip will and will not let you do appears to matter as much as the surgery itself.

Why the Rate of Hip Replacement Varies So Much by Country

The “average age” for hip replacement is not a universal constant. It is shaped heavily by national healthcare systems, access to orthopedic care, and economic development. Among OECD countries, utilization rates differ enormously. Countries like the United States, Switzerland, and Germany perform more than 200 hip replacements per 100,000 population per year. Spain’s rate is about half that, and Mexico’s is a tiny fraction.² Higher national wealth and healthcare spending per capita strongly correlate with higher surgical rates.

Within countries, socioeconomic status creates its own patterns. UK research found that patients from lower socioeconomic backgrounds and Black minority patients tended to be younger at the time of hip replacement and had more accompanying health problems.⁵ This is probably not because they develop arthritis earlier in a vacuum. It more likely reflects a combination of occupational exposure to joint stress, higher rates of obesity, and inequalities in how quickly they are referred for surgical evaluation. The “average age” for hip replacement, in practice, is partly a marker of who gets access to elective surgery and when.