FP9.8 Non-Tobacco Nicotine Dependence Is Associated With Increased Odds of Conversion to Total Hip Arthroplasty In Patients Undergoing Hip Arthroscopy Compared With Non-Nicotine Controls and Higher Opioid Prescription Rates Compared With Tobacco Nicotine Dependence Patients

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2026
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Abstract
Abstract ICLB09 - The Revision Playbook: Advanced Execution and Technical Rescues in Failed Preservation, Session Room 6 (BMCC Level 3), October 9, 2026, 10:30 - 12:30 Introduction Non-tobacco nicotine dependence (NTND) has been associated with inferior outcomes across orthopedic procedures, yet its effects on hip preservation remain poorly characterized. The purpose of this study is to compare adverse events, healthcare utilization, opioid prescriptions, and secondary surgery rates in patients undergoing hip arthroscopy with NTND compared with patients with no history of nicotine dependence and patients with tobacco-based nicotine dependence (TND). Methods A national database was used to identify patients who underwent hip arthroscopy between October 2003 and October 2023. Patients with Ehlers-Danlos syndrome or congenital hip deformities were excluded. NTND patients were propensity matched to (1) non-nicotine controls and (2) TND patients. Outcomes included 90-day healthcare utilization, adverse events, 90-day and 1-year opioid prescription rates, and 2-year secondary surgery rates, analyzed using Mann–Whitney U, chi-squared, or Kaplan–Meier survival analysis with log-rank testing. Results After propensity matching, 720 NTND patients were matched to 720 non-nicotine controls with a mean age of 40.3 ± 11.1 vs. 41.2 ± 12.9 years and 58.89% vs. 58.61% female respectively. NTND patients demonstrated higher emergency department (ED) visit (8.06% vs 4.58%, OR: 1.82, p=0.007) and opioid prescription rates (46.81% vs 32.92%, OR: 1.79, p<0.001) within 90 days, while adverse events and readmissions were similar. NTND patients also demonstrated higher 2-year total hip arthroplasty (THA) rates (5.28% vs 3.06 %, OR: 1.77, p=0.035) with similar revision hip arthroscopy rates. In the matched TND vs NTND comparison (356 per cohort), adverse events, ED visits, and secondary surgery rates were similar; however, TND patients demonstrated lower 90-day opioid prescription rates (49.16% vs 41.01%, OR 0.72, p=0.029), while 1-year opioid rates were similar. Conclusion Compared to non-nicotine controls, NTND patients demonstrated increased odds of 90-day ED visits, postoperative opioid prescriptions, and two-year conversion to THA following hip arthroscopy. In the comparison of NTND and TND, NTND patients had increased odds of 90-day opioid prescriptions, though postoperative adverse events and secondary surgery rates were similar. Significance/Clinical Relevance These findings suggest that non-tobacco nicotine use represents a distinct and underrecognized risk factor in hip arthroscopy, with a postoperative risk profile that may be comparable to that of tobacco-based nicotine dependence.
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Authors Scott Fong, Kevin Lord, Jacob Kodra, Michael Lee, Iyad Ali, Kevin Girardi, Jay T. Moran, Louise A. Atadja, Renato Locks, Arthur Saroyan, Jordan Kamen, PD Dr med Nils Becker, Andrew Jimenez
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.072
URL
https://doi.org/10.1093/jhps/hnag043.072
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