Abstract
From the joint registry of 2831 primary total hip arthroplasties (2351 patients) performed
between 1998 and 2003, we identified 15 patients (16 hips) who had a documented history
of substance abuse disorders at the time of the index surgery. The patients included
13 men (14 hips) and 2 women (2 hips), with the mean age of 49 years (range, 29-65
years). On the basis of the criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, 13 patients had alcohol abuse disorders, 1 had amphetamine abuse disorder, and 1
had heroin abuse disorder. We found high rates of postoperative substance withdrawal
delirium and psychosis (46%), late complication (25%), and lost to follow-up (27%)
in these patients. Because patients with substance abuse disorders have unexpected
perioperative psychotic episodes, poor compliance, and a tendency to not follow medical
advice after surgery and show early discontinuation of follow-up, we suggest that
surgeons should work with other medical professionals and carefully perform total
hip arthroplasty in such patients.
Keywords
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Article info
Publication history
Published online: February 10, 2012
Accepted:
December 6,
2011
Received:
June 9,
2011
Footnotes
The conflict of interest statement associated with this article can be found at doi:10.1016/j.arth.2011.12.003.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
