Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, North Carolina, U.S.A..
Division of Sports Medicine, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A.
Arthroscopy. 2020 Jun;36(6):1599-1607. doi: 10.1016/j.arthro.2020.02.007. Epub 2020 Feb 14.
To determine whether requiring postoperative opioid refills has an effect on both baseline and postoperative functional scores, as well as rates of achieving clinical success 2 years after hip arthroscopy for femoroacetabular impingement syndrome (FAIS).
Data from consecutive patients undergoing hip arthroscopy for FAIS from January 2012 to December 2016 were analyzed. Patients with at least 1 postoperative opioid refill were matched 1:2 by age and body mass index to patients not requiring refills. Preoperative and postoperative patient-reported outcomes including the Hip Outcome Score-Activities of Daily Living Subscale, HOS-Sports Subscale, and modified Hip Harris Score, as well as visual analog scale (VAS) pain and satisfaction surveys, were compared between the 2 groups, as well as between patients who requested 1 refill versus those requiring 2 or more refills. The minimal clinically important difference and patient acceptable symptomatic state (PASS) were calculated for the study group and compared between patient groups.
A total of 128 patients (14.5%) requesting at least 1 postoperative opioid refill and 256 with no refills were included in the study. Analysis showed that the refill group had lower patient-reported outcomes (P < .05 for all), a lower VAS satisfaction score average (73.2 ± 30.7 vs 80.1 ± 25.9, P = .029), and a higher VAS pain score average (27.2 ± 26.1 vs 19.9 ± 22.7, P = .007). Similar trends were seen when patients with 1 refill were compared with those with 2 or more refills. Analysis of meaningful clinical outcomes showed that patients in the refill group had lower rates of achieving the PASS (68.3% vs 77.2%, P = .006). However, there were no statistically significant differences in achieving the minimal clinically important difference between the 2 groups (P > .05 for all).
Patients undergoing hip arthroscopy for FAIS who require 1 or more opioid refills postoperatively are likely to have lower baseline and postoperative functional scores, as well as to achieve the PASS at lower rates, compared with patients who do not require an additional opioid prescription to what is routinely given after surgery.
Level III, retrospective case-control study.
确定髋关节镜治疗股骨髋臼撞击综合征（FAIS）术后是否需要补充阿片类药物对基线和术后功能评分以及术后 2 年临床成功率的影响。
分析了 2012 年 1 月至 2016 年 12 月期间连续接受髋关节镜治疗 FAIS 的患者的数据。根据年龄和体重指数，将至少 1 次术后阿片类药物补充的患者与不需要补充的患者进行 1:2 匹配。比较两组患者术前和术后的患者报告结局，包括髋关节评分-日常生活活动量表（HOS-ADL）、HOS-运动量表和改良 Harris 髋关节评分，以及视觉模拟量表（VAS）疼痛和满意度调查。比较两组患者中要求补充 1 次药物与要求补充 2 次或更多次药物的患者之间的差异。计算研究组的最小临床重要差异和患者可接受的症状状态（PASS），并比较患者组之间的差异。
共纳入 128 例（14.5%）至少要求 1 次术后阿片类药物补充的患者和 256 例无补充的患者。分析表明，补充组患者的患者报告结局较低（所有 P <.05），VAS 满意度评分平均值较低（73.2 ± 30.7 与 80.1 ± 25.9，P =.029），VAS 疼痛评分平均值较高（27.2 ± 26.1 与 19.9 ± 22.7，P =.007）。当比较仅要求 1 次补充的患者与要求 2 次或更多次补充的患者时，也出现了类似的趋势。有意义的临床结局分析表明，补充组患者达到 PASS 的比例较低（68.3%与 77.2%，P =.006）。然而，两组之间达到最小临床重要差异的比例没有统计学差异（所有 P >.05）。
与术后不需要额外阿片类药物处方（常规手术后给予）的患者相比，接受髋关节镜治疗 FAIS 的患者术后需要 1 次或更多次阿片类药物补充的患者，其基线和术后功能评分可能较低，达到 PASS 的比例也较低。
三级，回顾性病例对照研究。
