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Preoperative opioid use linked with increased risk of prolonged use after hip arthroscopy
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Published results showed preoperative opioid analgesic use was the most significant risk factor for prolonged opioid analgesic use in patients undergoing hip arthroscopy.
“Patients who are candidates for hip arthroscopy should be counseled about the dangers of opioid use,” Brian C. Werner, MD, co-author of the study, told Healio.com/Orthopedics. “There is clearly a link between preoperative opioid use and prolonged postoperative opioid use, as well as several important adverse events after hip arthroscopy.”
Werner and colleagues identified 1,708 patients who underwent hip arthroscopy from 2007 to 2015 with a minimum of 6 months follow-up. Researchers determined independent risk factors for prolonged opioid analgesic use and examined preoperative and prolonged opioid analgesic use as risk factors for complications.
Results showed 27.9% of patients received prescriptions for preoperative opioid analgesics and 27.4% of patients had prolonged postoperative opioid analgesic use. Researchers noted preoperative and prolonged postoperative opioid analgesic use had a significantly decreasing trend. Preoperative opioid analgesic use was the most significant risk factor for prolonged postoperative use, according to results, and was a significant risk factor for postoperative complications, including emergency room visits and conversion to total hip arthroplasty. Researchers also found other preoperative prescriptions, including muscle relaxants and anxiolytics, to be significant risk factors for prolonged postoperative opioid analgesic use. Results showed an association between prolonged postoperative opioid analgesic use with a higher risk of revision hip arthroscopy and conversation to THA.
“In our study, over a quarter of patients were receiving prescriptions for narcotics more than 3 months after surgery, and the biggest risk factor for this prolonged use was the degree of preoperative use,” Werner said. “We would recommend that assessing for preoperative opioid use become a standard part of the presurgical risk stratification in patients who are candidates for hip arthroscopy. While certainly not an exclusion criteria for surgery, we found a distinct relationship between preoperative opioid use and prolonged postoperative use, as well as several adverse postoperative events.” – by Casey Tingle
Disclosures: Werner reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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