Outcomes of Preoperative Opioid Usage in Hip Arthroscopy: A Comparison With Opioid-Naive Patients

Purpose: To compare postoperative outcomes between opioid-naive patients and patients with a history of preoperative opioid usage undergoing hip arthroscopy. The secondary purpose is to determine whether preoperative opioid users consumed more oral morphine milligram equivalents than opioid-naive patients following surgery. Methods: This is a single-center, retrospective analysis comparing outcomes and postoperative opioid usage between patients with and without a history of preoperative opioid use. Inclusion criteria included patients >= 18 years, Tonnis grade 0 or 1, imaging consistent with FAI or labral pathology, and a diagnosis of symptomatic FAI requiring hip arthroscopy. Patient outcomes were compared throughout a 2-year follow-up using the modified Harris Hip Score, Nonarthritic Hip Score, and visual analog scale (VAS). Results: In total, 17 patients were evaluated in each cohort. The mean age of the study cohort and control cohort were 52.0 +/- 9.4 years and 51.2 +/- 12.2 years, respectively. Female patients were 58.8% (n = 10) of both cohorts. Non-naive patients had a lower preoperative Nonarthritic Hip Score (P = .05) and a greater VAS at their 6-month and 1-year (P < .001) postoperative visits. Naive patients reported greater modified Harris Hip Scores 2 years postoperatively (P < .001). The study cohort was prescribed greater levels of oral morphine equivalents at the postoperative 1-year visit (P = .05). Opioid-naive patients were more likely to reach minimally clinically important difference and patient acceptable symptom state of VAS at a faster rate. At the 2-year follow-up, 11.8% of opioid-naive patients continued to take opioids compared with 58.8% from the non-naive group for persistent hip pain (P < .001). Conclusions: We determined that preoperative opioid usage in patients undergoing hip arthroscopy is associated with inferior outcomes compared with opioid-naive patients. In addition, preoperative opioid users are likely to continue the use of opioid medications postoperatively and at greater doses than opioid-naive patients.