Evans JT, Blom AW, Timperley AJ, et al. - This research was sought to assess if the statistically improved implant survival of total hip replacement (THR) in a high-performing unit is correlated with the implants used or other factors at that unit, such as surgical skill. Researchers examined a national, mandatory, prospective, cohort study (National Joint Registry for England, Wales, Northern Ireland and the Isle of Man [NJR]) of all THRs performed in England and Wales including a total of 664,761 patients with records in the NJR who have received a stemmed primary THR between 1 April 2003 and 31 December 2017 in one of 461 hospitals, with osteoarthritis as the only indication. The outcomes imply that the “better than expected” implant survival outcomes of this exemplar center are correlated with implant choice. The data demonstrate that survival outcomes may be replicated by adopting key treatment decisions, such as implant selection and these decisions are easier to replicate than technical skills or system factors.