Acute Delirium and Poor Compliance in Total Hip Arthroplasty Patients With Substance Abuse Disorders

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 wome...

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Bibliographic Details
Published in:The Journal of arthroplasty 2012-09, Vol.27 (8), p.1526-1529
Main Authors: Yu, Yi-Hsun, MD, Chen, Alvin C.-Y., MD, Hu, Chih-Chien, MD, Hsieh, Pang-Hsin, MD, Ueng, Steve W.N., MD, Lee, Mel S., MD, PhD
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Aged
alcohol
Arthroplasty, Replacement, Hip
delirium
Delirium - etiology
Female
hip arthroplasty
Humans
Male
Middle Aged
Orthopedics
Patient Compliance
Postoperative Complications - etiology
substance abuse
Substance-Related Disorders - complications
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Summary: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.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2011.12.003