In International Orthopaedics, Liu et al. [1] showed mortality rates of primary hip arthroplasty from 0.32 % in 1990 to 0.29 % in 2004 in the United States. In the Lancet Hunt et al. [2] found that the 90-day mortality after total hip replacements fell substantially from 0.56 % in 2003 to 0.29 % in 2011 for England and Wales. Although they propose improvements of general health, surgical technique and anaesthesia for this finding, Liu et al. and Hunt et al. miss advances in rehabilitation therapy as a likely factor.
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