Pain Scores and Activity Tolerance in the Early Postoperative Period After Hip Arthroscopy

Abstract

Background: Despite the rapid growth in the use of hip arthroscopy, standardized data on postoperative pain scores and activity level are lacking. Purpose: To quantify narcotic consumption and use of the stationary bicycle in the early postoperative period after hip arthroscopy. Study Design: Case series; Level of evidence, 4. Methods: In this prospective case series, patients undergoing a primary hip arthroscopy procedure by a single surgeon were asked to fill out a daily survey for 9 days postoperatively. Patients were asked to report their pain level each day on a visual analog scale from 1 to 10, along with the amount of narcotic pain pills they used during those postoperative days (PODs). Narcotic usage was converted to a morphine-equivalent dosage (MED) for each patient. Patients were also instructed to cycle daily starting on the night of surgery for a minimum of 3 minutes twice per day and were asked to rate their pain as a percentage of their preoperative pain level and the number of minutes spent cycling on a stationary bicycle per day. Results: A total of 212 patients were enrolled in this study. Pain levels (POD1, 5.5; POD4, 3.8; POD9, 2.9; P < .0001) and the percentage of preoperative pain (POD1, 51.6%; POD4, 31.8%; POD9, 29.5%; P < .01) significantly decreased over the study period. The amount of narcotics used per day (reported in MED) also significantly decreased (POD1, 27.3; POD4, 22.3; POD9, 8.5; P < .0001). By POD4, 41% of patients had discontinued all narcotics, and by POD9, 65% of patients were completely off narcotic medication. Patients were able to significantly increase the number of minutes spent cycling each day (POD1, 7.6 minutes; POD4, 13.8 minutes; POD9, 19.0 minutes; P < .0001). Patients who received a preoperative narcotic prescription for the affected hip were significantly more likely to require an additional postoperative narcotic prescription ( P < .001). Conclusion: Patients can expect a rapid decrease in narcotic consumption along with a high degree of activity tolerance in the early postoperative period after hip arthroscopy.

The Everted Acetabular Labrum: Outcomes of Surgical Management

“…Although both instruments were developed to measure hip dysfunction in prearthritic patients, the iHOT-12 is a demanding questionnaire requiring more active clinical improvement for score increases. 13,21,22 The more demanding nature of the iHOT-12 can be evidenced throughout our results, with iHOT-12 scores consistently lower than NAHSs within the same cohorts, which is suggestive of a ceiling effect of NAHS in more active patients. 19 Authors have argued that the iHOT-12 is the most appropriate PRO measure for most patients because it is comprehensive and is well-suited for the general population.…”

The Addition of a Pericapsular Nerve Group Block for Postoperative Pain Control Does Not Result in Less Narcotic Use After Hip Arthroscopy: A Systematic Review

“…Opioid prescriptions are often part of the postoperative plan, and orthopaedic surgeons are the third-highest prescribers of narcotic medications. 18 Given the pervasive opiate crisis, alternative methods of appropriate pain management are more desirable. A systematic review of randomized controlled trials published in 2021 evaluated the use of the fascia iliaca block for postoperative pain control after hip arthroscopy.…”

Comparative efficacy analysis of ultrasound-guided quadratus lumborum block and lumbar plexus block in hip arthroscopy: a pilot prospective randomized controlled trial

“…Compared with open hip surgery, hip arthroscopy has the advantages of a small surgical incision and reduced damage to the joint cavity and surrounding soft tissues [ 3 ]. Hip arthroscopy is a comprehensive therapeutic process, and post-operative rehabilitation is crucial for its therapeutic effect; however, obvious post-operative pain limits its application [ 4 ].…”