OBJECTIVES:To quantify the likelihood of hip replacement (HR) surgery at a population level up to 15 years after sports injury. DESIGN:Cohort study. SETTINGS:Public and private hospitals in the state of Victoria, Australia. PARTICIPANTS:The cohort was established by linking administrative datasets capturing all hospital admissions and emergency department (ED) presentations. All sports injury presentations from 2000 to 2005 and HR admissions from 2000 to 2015 were identified using ICD-10-AM codes. MAIN OUTCOME MEASURES:Time to HR (number of days from sports injury admission to HR admission). RESULTS:Over the study period there were 64,750 sports injuries (including 815 hip or thigh musculoskeletal injuries) that resulted in ED presentation or hospitalisation, and 368 HR procedures. Compared to all other sports injuries, having a hip or thigh injury tripled the hazard of subsequent HR in multivariate analysis (hazard ratio 3.07, 95%CI 2.00-4.72). Of the main hip or thigh injury types, femoral fractures (hazard ratio 3.08, 95%CI 1.77-5.36) and hip dislocations (hazard ratio 5.64, 95%CI 2.34-13.58) were significantly associated with HR. CONCLUSION:Sports-related hip or thigh musculoskeletal injury is associated with a significantly higher likelihood of HR within 15 years. Effective injury prevention and appropriate post-injury management are needed to curtail this population burden.