Patients Requiring Postoperative Opioid Prescription Refills Have Similar Long-Term Clinical Outcomes to Those Not Requiring Refills After Hip Arthroscopy for Femoroacetabular Impingement Syndrome.

Abstract

To identify long-term patient-reported outcomes (PROs), achievement of clinically significant outcomes, and reoperation rates after primary hip arthroscopy for femoroacetabular impingement between patients requesting at least 1 postoperative opioid refill after hip arthroscopy and patients not requesting a refill. Patients who underwent hip arthroscopy between January 2012 and October 2014 with minimum 10-year follow-up were included. Patients who had received at least 1 opioid refill were propensity matched 1:1 to patients who did not receive a refill, controlling for age, sex, and body mass index (BMI). Patients completed PROs including the Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sports Subscale, modified Harris Hip Score, and visual analog scale scores for pain and satisfaction. Clinically significant outcomes obtained at 10-year follow-up included the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS). A Kaplan-Meier analysis was performed to evaluate survivorship between cohorts. Seventy-four patients who received opioid refills (age, 35.1 ± 11.7 years; 67.6% female sex; BMI, 26.3 ± 5.8) were successfully matched to 74 patients who did not receive a refill (age, 36.9 ± 11.1 years; 68.9% female sex; BMI, 26.1 ± 5.4). There were no significant differences in patient demographic characteristics. Refill group patients showed worse scores for preoperative Hip Outcome Score-Activities of Daily Living; preoperative, 1-year postoperative, and 5-year postoperative modified Harris Hip Score; and 1-year postoperative Hip Outcome Score-Sports Subscale. All other PROs at each time point were not significantly different. Maximum observable improvement did not differ between groups. Groups did not differ in 10-year MCID achievement (98.1 vs 94.0) or PASS achievement (75.9 vs 81.1). Time-dependent survivorship was similar between groups. Male and female opioid who received refills had similar 10-year outcomes and reoperation rates. After primary hip arthroscopy, patients who require opioid refills have significantly worse PROs at short- and mid-term follow-up, with no differences in PROs, achievement of the MCID or PASS, and reoperation rates at long-term follow-up. Level III, retrospective, comparative case-control series.