More Than 25% of Hip Arthroscopy Patients Get Opioids

A multicenter study has explored, among other things, several risk factors for prolonged opioid use after hip arthroscopy.

The study “Perioperative Opioid Analgesics and Hip Arthroscopy: Trends, Risk Factors for Prolonged Use, and Complications,” appears in the August 2018 edition of The Journal of Arthroscopic and Related Surgery.

Co-author Brian Werner, M.D., assistant professor of orthopedic surgery, University of Virginia health system told OTW, “This manuscript is one of several papers we have published looking at the impact of opioid use on orthopedic surgery. We were led to this topic by the recent emphasis in the media on the opioid epidemic in the United States. The first step to understanding how we can reduce opioid use is to truly determine the use and impact of opioids in orthopedic surgery.”

According to the authors, “The purpose of this article is to:

• examine trends in preoperative and prolonged postoperative opioid analgesic use in patients undergoing hip arthroscopy,
• characterize risk factors for prolonged opioid analgesic use following hip arthroscopy, and
• explore preoperative and prolonged postoperative opioid analgesic use as independent risk factors for complications following hip arthroscopy.”

“A private insurance database was queried for patients undergoing hip arthroscopy from 2007 to 2015 with a minimum of 6 months of follow-up. Independent risk factors for prolonged opioid analgesic use were determined. Preoperative and prolonged opioid analgesic use as risk factors for complications were examined.”

Dr. Werner told OTW, “The most significant results were that over a quarter of patients undergoing hip arthroscopy continued to receive opioid analgesic prescriptions more than three months postoperatively. While some of these likely represent patients who take chronic opioids, this highlights the need for improvement. We also identified several risk factors for prolonged opioid use after hip arthroscopy, the most significant of which was the degree of preoperative opioid use.”

“Patients should be counseled about the dangers of opioid use. There is clearly a link between preoperative opioid use and prolonged postoperative opioid use, as well as several important adverse events after hip arthroscopy.”

“We would recommend that assessing for preoperative opioid use become a standard part of the pre-surgical risk stratification in patients who are candidates for hip arthroscopy. While certainly not an exclusion criteria for surgery, our data found a distinct relationship between preoperative opioid use and prolonged postoperative use, as well as several adverse postoperative events.”