Effect of Preoperative Opioid Consumption on Outcomes After Hip Arthroscopy for Femoroacetabular Impingement and Labral Tears: A Minimum 2-Year Follow-up Study

Background: There is a paucity of literature investigating the effect of preoperative opioid use on outcomes after hip arthroscopy. Purpose: To evaluate the short-term outcomes and the recovery curve of patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) and labral tears who reported preoperative opioid use and to compare these results to a control group of patients without preoperative opioid use. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively analyzed data for patients who underwent primary hip arthroscopy for FAI and labral tears between 2009 and 2021. Patients were included if they reported daily opioid-based pain management within 1 year of surgery (preoperative opioid [PO] group) and had completed preoperative and postoperative patient-reported outcome (PRO) measures at 2-year follow-up. Patients were propensity score matched in a 1:1 ratio to a control group based on sex, age, body mass index, acetabular Outerbridge grade, and labral and capsular treatment. Analysis included comparisons of PROs at 3 months, 1 year, and 2 years as well as clinical thresholds and secondary surgery. Results: A total of 236 patients in the PO group were matched to 236 control cases. The PO group demonstrated significant improvements on all PRO measures at 2-year follow-up. Compared to the control group, the PO group had lower preoperative scores for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and Hip Outcome Score–Sports-Specific Subscale (HOS-SSS) and experienced a prolonged recovery, as indicated by lower mHHS and HOS-SSS scores at 3 months and lower mHHS, HOS-SSS and NAHS scores at 1 year. However, by 2-year follow-up, the PO group achieved comparable scores for the mHHS, NAHS, HOS-SSS, and visual analog scale (VAS). Despite these improvements, the PO group reported lower patient satisfaction compared to the control group (6.3 vs 8.7, respectively; P = .03), reaching the PASS for the VAS at a lower rate ( P = .03). No significant differences were observed for secondary surgery rates. Conclusion: Hip arthroscopy for the treatment of FAI and labral tears in patients using daily opioid-based pain control resulted in significant short-term improvements in PROs. Compared to a control group, these patients experienced a prolonged recovery process but ultimately achieved comparable functional outcomes at 2-year follow-up. Despite these improvements, they reported lower patient satisfaction and met the PASS for the VAS at a lower rate.