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Joint replacement in Germany: Procedure year 2025 in key takeaways

This year’s Endoprothesenregister Deutschland (EPRD) Annual Report sets a registry record, with 422,368 hip and knee procedures documented. Knee documentation has grown by about 29% since 2022, and hip documentation by 11%.

Slide with a pink femoral head rendering and text stating ceramic heads were used in 91.6% of elective THA.
Stacked bar chart comparing hip stem categories from 2012/13 to 2025, with a hip implant illustration.
Stacked bar chart of hip femoral head sizes from 2012/13 to 2025, alongside a hip implant illustration.
Stacked bar chart of cemented and cementless hip stems in patients aged 75 and older, 2012/13–2025.
German-language slide listing infection, loosening and other hip follow-up procedure findings.
Stacked bar chart of reasons for hip follow-up procedures from 2012/13 to 2025.

Here are the key findings for the hip joints.

 

Hip (201,487 primary procedures in 2025):

 

  • Approach: Elective total hip arthroplasty (THA) made up 83.0% of recorded cases. Cementless fixation remains prevalent (78.1%), followed by hybrid (19.0%) and cemented (2.3%).
  • Material + size: Ceramic femoral heads were used in 91.6% of elective THA. 36 mm is the most common head size (59.1%). Short stems make up 23.7% of all primary THA – growing annually since 2018.
  • Revision reasons: Infection + loosening (each 20.2%), periprosthetic fracture (16.3%), dislocation (13.4%).
  • 10-year failure (any further component-changing procedure): 4.8% for elective cementless THA. By bearing: CoC 3.8%, CoHXLPE 4.8%, CoHXLPE + antioxidant 4.0%, MoHXLPE 6.8%, CoPE 7.0%.

 

Shared patterns:

 

  • Failure risk rose after revision and with each additional procedure.
  • Higher BMI was linked to higher failure risk in both joints.
  • Men showed higher hip failure rates; younger patients showed higher knee failure rates.

 

Mismatch and quality flags

 

  • Hip: 58 replacements showed head and insert or cup size discrepancies, plus 4 stem-taper mismatches.
  • Knee: 123 implants used size combinations outside manufacturer limits, out of more than 62,000 TKA with defined combinations.
  • Some flags reflect classification or documentation errors, not true mismatches.

 

Patient perspective: PROMs appear in an EPRD annual report for the first time; therefore, case statistics are still limited.

 

The report stresses that implant characteristics and patient factors both shape outcomes. A differentiated, individualized assessment remains more useful than blanket recommendations.

 

📖 Endoprothesenregister Deutschland (EPRD). (2026). Jahresbericht 2026: Mit Sicherheit mehr Qualität. EPRD Deutsche Endoprothesenregister gGmbH. doi: 10.36186/reporteprd142026

 

Please check for regulatory approval in your country.

 

This post reflects CeramTec’s summary of a peer-reviewed scientific publication and does not constitute clinical guidance, risk prediction for individual patients, or product-related recommendations. For product, safety, and risk information, always refer to the labeling of the legal manufacturer.

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