Association of Preoperative Opioid Use and Smoking With Opioid Refill After Hip Arthroscopy
Philip Khoury, Sourabh Vellala, Michael A. McCurdy, Dominic J. Ventimiglia, Evan L. Honig, Joseph M. Blommer, R. Frank Henn, Sean J. MeredithBackground:
As the opioid epidemic continues to evolve, health care providers have implemented novel pain management strategies to reduce patient risk of developing opioid dependence, such as stricter prescribing laws and caps on opioid pain medications. Postoperative opioid consumption is particularly relevant to orthopaedic surgeons, as they are among the highest prescribers of opioids on a per-prescriber basis. Factors influencing postoperative opioid use have been well studied after knee and shoulder arthroscopy; however, literature in the hip arthroscopy population is scarce.
Purpose:
To investigate risk factors for refilling an opioid prescription within 3 months of hip arthroscopy.
Study Design:
Case-control study.
Methods:
Patients undergoing hip arthroscopy for femoroacetabular impingement syndrome or labral tear between November 2015 and June 2022 were identified from an orthopaedic registry. Patients completed surveys at baseline and 2 years postoperatively. Surveys included 6 computer-adaptive testing Patient-Reported Outcome Measurement Information System domains, numeric pain scales, activity scales (Tegner, Marx), and Musculoskeletal Outcomes Data Evaluation and Management System expectations domains. The Prescription Drug Monitoring Program was reviewed to record perioperative opioid prescriptions filled between 1 year preoperatively and 2 years postoperatively. Morphine milligram equivalents (MMEs) were calculated for each prescription.
Results:
A total of 124 patients were included for analysis, of whom 18 (14.5%) refilled an opioid prescription within 3 months of surgery. Smoking (
Conclusion:
In a cohort of hip arthroscopy patients, preoperative opioid use and smoking were independent predictors of refilling an opioid prescription within 3 months postoperatively. These findings suggest that smoking and preoperative opioid use may be topics to address during preoperative counseling of these patients.