Long-term outcomes of traumatic hip dislocation: a minimum 10-year follow-up study in 18 patients

Traumatic hip dislocations are rare but serious injuries, potentially affecting patients' quality of life and mobility. Given the limited understanding of prognostic factors, this study aimed to identify predictors of long-term clinical outcomes.

Injury characteristics and computed tomography (CT) of patients following traumatic hip dislocation from two level I trauma centers from 2009 to 2015 were analyzed. At follow-up, patients were evaluated for avascular necrosis (AVN), post-traumatic osteoarthritis (PTOA), secondary surgery, complications, and return to sports. Patient-reported outcome measures (PROMs), including Tegner Activity Scale (TAS) and modified Harris Hip Score (mHHS), were evaluated.

38 patients with traumatic hip dislocation were finally included. Concomitant posterior acetabular wall fractures and femoral head fractures (Pipkin type I to IV) were observed in 34 cases (87%). 18 patients (mean age 38.3 ± 17.2 years) completed the follow-up (mean follow-up 12.25 ± 1.03 years). 6 patients (33%) developed PTOA, 2 patients (11%) AVN, and 3 patients (17%) required total hip arthroplasty. Decreased TAS was associated with concomitant fractures (p = 0.02). 10 patients (56%) did not return to their pre-injury sports level and 7 patients (39%) reported sexual dysfunction. PROMs and return to sports were significantly worse in patients with PTOA or residual sciatic nerve injury (p < 0.05).

Patients after traumatic hip dislocation are at high risk for PTOA or AVN, especially with concomitant acetabular or femoral head fractures, resulting in significant long-term limitations in daily activities, sports, and sexual function. Recognition of concomitant fractures is a critical prognostic factor in assessing long-term outcomes.