Preoperative Opioid Use Negatively Affects Patient-reported Outcomes After Primary Total Hip Arthroplasty

J Am Acad Orthop Surg. 2019 Nov 15;27(22):e1016-e1020. doi: 10.5435/JAAOS-D-18-00658.


Background: Opioid use is a public health crisis in the United States and an area of increased focus in orthopaedic surgery. The aim of this study is to investigate whether preoperative opioid use had any effect on patient-reported outcome measures (PROMs) before and after total hip arthroplasty (THA).

Methods: A total of 389 patients with THA with both preoperative and postoperative PROMs were reviewed: (1) 76 patients with preoperative opioid use (24%) and (2) 237 patients without preoperative opioid use (76%). Patient demographics and clinical information including opioid use, length of stay, and implant information.

Results: Preoperative opioid users were more likely to stay in the hospital longer (P = 0.004) and be discharged to a rehabilitation facility (P = 0.038). Postoperatively, the Physical Function Short Form 10a (P = 0.021) and Patient-Reported Outcomes Measurement Information System Global-10 (P < 0.001 physical, P = 0.001, mental) were significantly lower in the preoperative opioid users. Within groups, both nonusers and preoperative opioid users saw improvements after THA in Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form (P < 0.001), Short Form 10a (P < 0.001), and Patient-Reported Outcomes Measurement Information System Global-10 (P < 0.001, physical and P = 0.008, mental).

Discussion: Although all patients reported improvements after THA regardless of preoperative opioid use, preoperative opioid users undergoing THA had significantly lower patient-reported outcome scores, longer hospital stays, and a more likely discharge to rehabilitation.

MeSH terms

  • Aged
  • Analgesics, Opioid / adverse effects*
  • Arthroplasty, Replacement, Hip*
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Preoperative Care*
  • United States


  • Analgesics, Opioid