Objectives: The aim of our study is to compare the differences in hip arthroplasty surgery between the state and private health care sectors in Hungary.

Methods: Patients with hip prosthesis surgery were selected by simple convenience sampling technique at the Department of Orthopedics, Clinical Centre of the University of Pécs and at the Da Vinci Private Clinic in Pécs. Patients completed a questionnaire about the circumstances of the surgery (surgical procedure, approach, fixation, anaesthesia, drainage, blood transfusion).

Results: The research involved 208 persons, 96 persons (40 male, 56 female, mean age: 64.33 years) in the state, 112 persons (53 male, 59 female, mean age: 63.36 years) in the private sector. The main surgical indication was coxarthrosis. There is a significant difference in the type of surgical approach, as the state care mainly uses anterolateral approach (96.88%) and the private care only anterior approach (100%). There is also a large difference in the type of surgical procedure, with patients in the state sector undergoing traditional surgery (98.96%) and patients in the private sector undergoing minimal invasive surgery (100%). In the state sector the proportion of cemented fixation (p<0.001), while in the private sector the proportion of non-cemented fixation was significantly higher (p<0.001). The proportion of general anaesthesia was significantly higher in the state sector (p<0.001) and on the private side, combined anaesthesia (p<0.001) and stunning (p=0.013). Blood transfusions were required in 30.21% of patients in the state sector compared to only one patient (0.89%) in the private sector (p<0.001). While drain insertion occurred in 98.96% of the state care, only 34.82% in the private sector (p<0.001).

Conclusions: Our results show that the state and private sectors have different surgical preferences for total hip arthroplasty surgery. The type of surgical procedure is largely determined by the institution and the surgeon's preference.