Prior Diagnosis of Opioid-Related Disorder Is Associated With Higher Medical Resource Utilization Following Primary Hip Arthroscopy: A National Database Study

Peter F Monahan; Serkan Surucu; Natalie K Pahapill; Andrew E Jimenez; Kenneth F Taylor

doi:10.1016/j.arthro.2023.12.008

Prior Diagnosis of Opioid-Related Disorder Is Associated With Higher Medical Resource Utilization Following Primary Hip Arthroscopy: A National Database Study

Arthroscopy. 2023 Dec 22:S0749-8063(23)01012-5. doi: 10.1016/j.arthro.2023.12.008. Online ahead of print.

Authors

Peter F Monahan¹, Serkan Surucu², Natalie K Pahapill³, Andrew E Jimenez², Kenneth F Taylor⁴

Affiliations

¹ Penn State College of Medicine, Hershey, Pennsylvania, U.S.A.. Electronic address: pmonahan@pennstatehealth.psu.edu.
² Department of Orthopaedic and Rehabilitation, Yale University, New Haven, Connecticut, U.S.A.
³ Penn State College of Medicine, Hershey, Pennsylvania, U.S.A.
⁴ Department of Orthopaedics and Rehabilitation, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, U.S.A.

PMID: 38142868
DOI: 10.1016/j.arthro.2023.12.008

Abstract

Purpose: To compare adverse events, medical resource utilization, prescribing patterns, and revision surgery rates of patients with opioid-related disorders (ORDs) undergoing primary hip arthroscopy against a propensity-matched group with no opioid-related disorders (NORDs).

Methods: The TriNetX database was queried between January 2015 and December 2020 using International Classification of Diseases, 10th Revision and Current Procedural Terminology codes to identify patients undergoing primary hip arthroscopy between ages 18 and 70 years. The ORD cohort was propensity matched in a 1:1 ratio to NORD patients based on age, sex, alcohol-related disorders, heart disease, hypertension, metabolic disorders, anxiety disorders, major depressive disorder, diabetes mellitus, and antidepressant prescriptions. Postoperative rates of adverse events and medical resources were compared within 90 days of procedure, prescriptions were compared within 1 year, and revision surgery was compared within 2 years.

Results: A total of 809 ORD patients were propensity matched in a 1:1 ratio to NORD patients. Postoperative adverse events were similar between groups (P = .693). Rates of revision arthroscopy were also similar for both ORD (9.3%) and NORD (8.0%) cohorts (odds ratio [OR], 1.17; 95% confidence interval [CI], 0.83-1.66; P = .377). ORD patients received care from the emergency department, inpatient admission, outpatient visit, and physical therapy evaluations at higher rates. The ORD cohort received a greater amount of new opioid (OR, 2.66; 95% CI, 2.17-3.26; P < .0001) and antidepressant prescriptions (OR, 1.58; 95% CI, 1.26-1.97; P < .0001) compared to NORD patients within 1 year of surgery.

Conclusions: ORD patients demonstrated similar rates of adverse events and revision surgery when compared to a propensity-matched group of NORD patients undergoing primary hip arthroscopy. However, ORD patients experienced increased rates of emergency department visits and hospitalizations and were prescribed higher rates of opioid and antidepressant prescriptions.

Level of evidence: Level III, cohort study.