Patients With Preoperative Fibromyalgia Undergoing Hip Arthroscopy Demonstrated Increased Odds of Postoperative Opioid Prescriptions Within 90 Days and 1 Year but Similar 2-Year Reoperation Rates Compared to Matched Controls.

Abstract

To compare adverse events, secondary surgery rates, opioid prescriptions, and medical resource utilization between patients undergoing hip arthroscopy with fibromyalgia and a propensity-matched control group without fibromyalgia. A retrospective review of the TriNetX national database identified patients who underwent hip arthroscopy between October 2015 and July 2023 with a preoperative fibromyalgia diagnosis. Propensity 1:1 matching was performed with controls who underwent hip arthroscopy without fibromyalgia. Postoperative adverse events, medical service utilization, opioid prescriptions, and secondary surgery rates were compared within 90 days, 1 year, and/or 2 years using Mann-Whitney U and χ² tests. A total of 755 patients with fibromyalgia were matched to 755 controls. Mean age was similar (41.5 ± 10.7 vs 41.4 ± 11.6 years, P = .813), with comparable female representation (78.7% vs 78.4%, P = .900). No significant differences were found in revision arthroscopy (odds ratio [OR] 0.91, 95% confidence interval [CI]: 0.68-1.21, P = .502) or conversion to total hip arthroplasty (OR 1.07, 95% CI: 0.65-1.76, P = .798) within 2 years. Patients with fibromyalgia had higher odds of opioid prescription within 90 days (OR 1.56, 95% CI: 1.27-1.91, P < .001) and 1 year (OR 1.41, 95% CI: 1.15-1.74, P < .001) postoperatively. Rates of adverse medical events, mean prescriptions per patient (among those prescribed), secondary surgeries, and medical service utilization did not differ. Contrary to the initial hypothesis, fibromyalgia was not associated with increased risk of postoperative adverse events, medical service utilization, revision surgery, or conversion to total hip arthroplasty after hip arthroscopy compared to the matched control. However, patients with fibromyalgia had significantly higher odds of receiving opioid prescriptions within both 90 days and 1 year postoperatively. Among those prescribed opioids, the mean number of prescriptions per patient did not differ significantly between cohorts. Level III, retrospective comparative case series.