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Journal of Hip Preservation Surgery
By Thomas J. Youm, Mr Rushani Cameron, Miss Isabella Jazrawi and 6 others.
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Abstract ICLA16 - Beyond the Operating Room: Value-Based Healthcare, Large Registries, and Predicting Failures, Auditorium B (BMCC Level 1), October 9, 2026, 14:00 - 16:00 Purpose The purpose of this study was to evaluate the association between preoperative mental health diagnoses, psychotropic medication use, and a high-risk psychiatric triad (anxiety, depression, and psychotropic medication use) with surgical failure, patient-reported outcomes, and failure-free survivorship following hip arthroscopy for FAIS. Methods A retrospective cohort study was performed on 243 adult patients who underwent primary hip arthroscopy for FAIS between 2010 and 2014. Mental health status and psychotropic medication use at the time of surgery was determined by medical record review. Surgical failure was defined as revision hip arthroscopy or conversion to total hip arthroplasty. Kaplan–Meier analysis was used to assess failure-free survivorship. Univariate and multivariable logistic regression analyses were performed to evaluate associations between psychiatric variables and failure. Patient-reported outcome measures (PROMs) including modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS) were evaluated preoperatively and at latest follow up. Results Mental health diagnoses were present in 73 patients (30.0%), and psychotropic medication use was identified in 51 patients (70.0% of those with a mental health diagnosis). Surgical failure occurred in 26 patients (10.7%) overall and was significantly more common among patients with a mental health diagnosis compared with those without (23% vs 5.3%, p< 0.001). Patients with mental illness demonstrated significantly inferior failure-free survivorship compared to patients without (11.49 vs 13.68 years; p = 0.0105) and lower 2-, 5-, and 10-year survivorship. On adjusted multivariable analysis, anxiety ( OR 5.83; 95% CI, 2.37–15.07; p < 0.001), depression ( OR 4.41; 95% CI, 1.71–11.17; p = 0.0018), combined anxiety and depression ( OR 5.53; 95% CI, 1.93–15.48; p = 0.0011), psychotropic medication use( OR 6.27; 95% CI, 2.33–17.87; p < 0.001), and psychiatric triad (OR 5.63; 95% CI, 1.73–17.34; p = 0.0029)were each independently associated with increased odds of surgical failure . Despite significant postoperative improvement in patient-reported outcomes in both cohorts, patients with mental illness demonstrated lower postoperative scores. Conclusion Mental health diagnoses and psychotropic medication use are independently associated with increased surgical failure and reduced long-term survivorship following hip arthroscopy for FAIS. Patients meeting criteria for a high-risk psychiatric triad represent a particularly vulnerable subgroup. Integration of mental health screening into preoperative evaluation may improve risk stratification and shared decision making in hip preservation surgery.
Published in Journal of Hip Preservation Surgery. The abstract is shown as published and remains the work of its authors; read the full article at the source.
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