What’s New in Hip Surgery 2026

Key findings in hip surgery are presented in the new JBJS Specialty Update, What’s New in Hip Surgery. Here, we summarize 5 standout studies, as selected by the lead author, Seper Ekhtiari, MD, MSc, FRCSC. 

Nonoperative Management

In a randomized trial of 109 patients with severe hip osteoarthritis, total hip arthroplasty (THA) was compared with a 12-week program of supervised resistance training. The THA group demonstrated greater mean improvement in the Oxford Hip Score than the nonoperative group (15.9 vs 4.5 points). Additionally, 77% of patients in the nonoperative group proceeded to THA within 2 years¹. 

Technology and Component Design

The long-term survivorship of modern THA implants was assessed in an analysis of nearly 2 million implants. Based on data from national joint registries worldwide, the researchers found that implants with contemporary bearing surfaces (metal or ceramic-on-highly cross-linked polyethylene, or ceramic-on-ceramic) had 93.6% all-cause survivorship at 20 years². 

Surgical Techniques and Approaches

An award-winning randomized controlled trial investigated whether outcomes differed among 102 patients with a hip fracture who underwent hemiarthroplasty performed using an anterior vs. lateral approach. Patient function (Barthel-20 Index score) at 6 weeks did not differ by surgical approach, nor did secondary outcomes such as length of stay, pain score, 90-day mortality, or complications³. 

Perioperative Management

A database study evaluated the effects of perioperative use of a glucagon-like peptide-1 (GLP-1) agonist on THA outcomes in patients with morbid obesity (body mass index, ≥40 kg/m2). In this population, GLP-1 use was associated with lower rates of 90-day periprosthetic joint infection, readmission, overall medical complications, and hematoma formation compared with no GLP-1 use⁴. 

Hip Fracture Management

The cost-effectiveness of hemiarthroplasty with vs. without cement for the treatment of femoral neck fractures in patients >60 years old in the United States was analyzed using a Markov model. Hemiarthroplasty with cement saved $2,534 over 10 years compared with no cement and resulted in an additional 0.9 quality-adjusted life-year⁵.  

What’s New in Hip Surgery is freely available at JBJS.org. 

What’s New by Subspecialty

Each month, JBJS publishes a review of the most pertinent studies from the orthopaedic literature in a select subspecialty. To read the reports, visit the What’s New by Subspecialty collection at JBJS.org. 

Recent OrthoBuzz posts include: What’s New in Orthopaedic Rehabilitation, What’s New in Limb Lengthening and Deformity Correction, and What’s New in Musculoskeletal Infection. 

References 

1. Frydendal T, Christensen R, Mechlenburg I, Mikkelsen LR, Varnum C, Graversen AE, Kjærsgaard-Andersen P, Revald PH, Hofbauer C, Bieder MJ, Qassim H, Munir MS, Jakobsen SS, Nielsen SM, Ingwersen KG, Overgaard S. Total hip replacement or resistance training for severe hip osteoarthritis. N Engl J Med. 2024 Oct 31;391(17):1610-20. 
2. Pentland V, Thompson Z, Dayimu A, Demiris N, Bohm E, Campbell D, Lenguerrand E, Fenstad AM, Furnes ON, Hailer N, Hoit G, Kärrholm J, Kristensen TRB, Mäkelä K, Overgaard SR, Paxton E, Prentice H, Ravi B, Reed M, Rolfson O, Varnum C, Viitanen T, Waddell JP, Whitehouse M, Khoshbin A, Atrey A. Survivorship of modern total hip replacement to 30 years: systematic review, meta-analysis, and extrapolation of global joint registry data. Lancet. 2026 Feb 28;407(10531):855-66. 
3. Woolnough T, Horton I, Garceau S, Beaulé PE, Feibel RJ, Gofton W, Poitras S, Kim P, Grammatopoulos G. The John Charnley Award: The anterior approach does not improve recovery after hemiarthroplasty for femoral neck fracture. A randomized controlled trial. J Arthroplasty. 2025 Aug;40(8S1):S17-24.e1. 
4. Kim BI, Khilnani TK, LaValva SM, Goodman SM, Della Valle AG, Lee GC. Utilization of glucagon-like peptide-1 receptor agonist at the time of total hip arthroplasty for patients who have morbid obesity. J Arthroplasty. 2025 Sep;40(9S1):S259-264.e1. 
5. Varady NH, Oeding JF, Gausden EB, Ricci WM, Chen AF. Cemented hemiarthroplasty results in substantial cost savings over uncemented hemiarthroplasty for the treatment of femoral neck fractures in patients over 60 years old: a Markov analysis. J Arthroplasty. 2025 May;40(5):1239-45.