Psychological Healthcare Burden Lessens After Hip Arthroscopy for Those With Comorbid Depression or Anxiety

Anthony J. Zacharias, Nicole G. Lemaster, Gregory S. Hawk, Stephen T. Duncan, Katherine L. Thompson, Kate N. Jochimsen, Austin V. Stone, Cale A. Jacobs

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Purpose: In this study, we investigated whether patients undergoing arthroscopic treatment of femoral acetabular impingement syndrome (FAIS) seek health care for treatment of comorbid depression and anxiety in the year following hip arthroscopy. Methods: Using the Truven Health Marketscan database, FAIS patients who underwent hip arthroscopy between January 2009 and December 2016 were identified. Claims related to depression or anxiety filed during the year before surgery were required for inclusion. Using claims for pharmaceutical and psychological therapy treatments for mental health disorders, four groups of patients were analyzed on the basis of preoperative anxiety/depression treatment: medication only, therapy only, medication + therapy, and no treatment. Number of opioid pain prescriptions within 180 days prior to surgery and >90 days after hip arthroscopy were also compared. Results: Depression and anxiety claims were identified in 5,208/14,830 (35.1%) patients. Preoperative treatment for depression and anxiety included medication only (n = 648, 12.4%), therapy only (n = 899, 17.3%), medication + therapy (n = 252, 4.8%), and no treatment (n = 3,409, 65.5%). Of the 900 patients who filled an anxiety/depression-related prescription prior to surgery, 422 (46.9%) patients did not fill a similar prescription in the postoperative year. Of the 1,151 patients receiving anxiety/depression-related therapy prior to surgery, 549 (47.7%) did not receive therapy in the postoperative year. Preoperative opioid prescriptions were filled for 393 patients (60.6%) in medication-only group, 275 (30.6%) in therapy-only group, 156 (61.9%) in medication + therapy group, and 1,059 (31.1%) in the group receiving no treatment. Opioid prescriptions >90 days postoperatively were filled for 330 (50.9%), 225 (25.0%), 120 (47.6%), and 861 (25.3%) patients, respectively. Conclusion: Hip arthroscopy for FAIS is associated with a decreased postoperative use of health care resources for the treatment of depression and anxiety. Clinicians should also be aware of the potential interplay between preoperative psychotropic medication use and prolonged opioid use when counseling patients.

Original languageEnglish
Pages (from-to)e1171-e1175
JournalArthroscopy, Sports Medicine, and Rehabilitation
Issue number4
StatePublished - Aug 2021

Bibliographical note

Funding Information:
The authors report the following potential conflicts of interest or sources of funding: Dr. Stone is a committee member of AANA and AOSSM. He has received nonfinancial support from Flexion Therapuetics, Allosource, and Smith and Nephew, as well as grants from Arthrex, personal fees from Medwest Associates, nonfinancial support from Wright Medical, outside of the submitted work. Dr. Jacobs reports grants and personal fees from Flexion Therapeutics and from Smith & Nephew, outside the submitted work. Dr. Duncan reports grants and personal fees from Smith and Nephew; grants from Stryker, Zimmer/Biomet, Bone Support, and Medtronic; and personal fees from OrthAlign, Heraeus, and Bone Support, outside of the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.

Publisher Copyright:
© 2021 Arthroscopy Association of North America

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Public Health, Environmental and Occupational Health
  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation


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