Postoperative Opioid Use in Hip Arthroscopy for Femoroacetabular Impingement Syndrome Is Associated With Tobacco Use and Lower Preoperative Patient-Reported Outcome Measures.

Abstract

To investigate postoperative opioid use and patient-reported outcome measurement (PROM) data after primary or revision hip arthroscopy in the setting of femoroacetabular impingement syndrome. This was a retrospective study of demographic, radiographic, and PROM data of patients who underwent hip arthroscopy for femoroacetabular impingement syndrome between April 2021 and November 2023, completed a pain medication diary, and had a minimum of 1 year postoperative PROM follow-up. Patients recorded their postoperative pain medication use in a diary between surgery and their first postoperative visit. PROMs included Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference, PROMIS mobility, PROMIS anxiety, PROMIS depression, International Hip Outcome Tool, modified Harris Hip Score, and Hip Outcome Score (HOS)-Sport-Specific Subscale and Activities of Daily Living. Descriptive statistics were collected with Wilcoxon rank sums, Spearman correlation coefficients, and mixed modeling performed to analyze for significance and correlations. Our cohort included 105 participants (105 hips) with a mean age at surgery of 32.9 years (standard deviation 10.4). Mean total morphine milligram equivalents use before the first postoperative visit was 83.1 (standard deviation 82.8, range: 0-472.5), only 44% of the standard postoperative opioid prescription at our institution at the time of study. Tobacco use was associated with increased postoperative morphine milligram equivalents use (P = .002). Postoperative opioid use was negatively correlated with preoperative International Hip Outcome Tool, modified Harris Hip Score, HOS-Activities of Daily Living, HOS-Sport-Specific Subscale, and PROMIS mobility (r = -0.29, -0.21, -0.21, -0.37, -0.23, respectively; P all < .05) and positively correlated with PROMIS pain interference (r = 0.31, P = 0.004). Hip arthroscopy patients used on average less than 50% of their postoperative opioid prescription at our institution. Tobacco use was associated with increased postoperative opioid use and patients with lower preoperative PROM scores were more likely to use greater amounts of opioids after surgery. Level IV, retrospective case series.