Outcomes of Total Hip Arthroplasty for Traumatic versus Non-Traumatic Hip Pathology: A Prospective Cohort Study

Total hip arthroplasty (THA) is an established procedure for pain relief and functional restoration in both traumatic and non-traumatic hip pathologies, yet comparative data from the Indian population remain limited. This prospective study aimed to compare intraoperative parameters, early post-operative course, and 3-month functional outcomes of THA performed for traumatic femoral neck fractures versus heterogeneous non-traumatic etiologies in an Eastern Indian tertiary care center.

This single-center, prospective comparative study was conducted at All India Institute of Medical Sciences (AIIMS) Bhubaneswar between January 2021 and December 2022, after obtaining approval from the Institutional Ethics Committee, vide reference number (IEC/AIIMS BBSR/PG Thesis/2020-21/82). Forty-eight patients aged 30-70 were enrolled and divided into Group A (traumatic femoral neck fractures, n = 24) and Group B (non-traumatic etiologies, n = 24). All procedures were performed by a single surgeon using a standardized modified Hardinge approach with uncemented components. Key endpoints included the modified Harris hip score (MHHS) and the Visual Analog Scale (VAS) for pain at 3 months, along with intraoperative parameters and early post-operative complications.

Forty-eight patients were analyzed (24 traumatic, 24 non-traumatic), with the traumatic group significantly older than the non-traumatic group (55.17 versus 41.63 years, P < 0.001). Intraoperative surgical time, blood loss, need for transfusion, and early post-operative indices, including drain output, length of stay, and serial VAS scores, showed no significant differences between groups (all P > 0.05). Two intraoperative periprosthetic femoral fractures (8.3%) occurred in the traumatic group and none in the non-traumatic group, while at 3 months, MHHS (65.75 vs. 69.96, P = 0.11), VAS, gait parameters, use of walking aids, and sit-to-stand time were comparable, with no dislocations, deep infections, loosening, or revisions in either group.

THA provided similar early pain relief and functional recovery at 3 months for both traumatic femoral neck fractures and non-traumatic hip pathologies in this Eastern Indian cohort. Although the older traumatic group demonstrated a higher, clinically relevant but statistically insignificant rate of intraoperative periprosthetic fractures, overall early complication profiles and functional outcomes were comparable, supporting THA as a reliable option for both indications while underscoring the need for careful femoral preparation in older fracture patients and for longer-term studies with larger, matched cohorts to evaluate implant survivorship and late complications.