Methamphetamines & Acetabular Reoperation Rates: Poor Outcomes from the Front Lines.

OBJECTIVES To compare acetabular fracture reoperation rates within one year of surgery in methamphetamine ("meth") abusers and abstainers. DESIGN Retrospective database analysis. SETTING Level 1 academic trauma facility, 2008-2018. PATIENTS/PARTICIPANTS 371 patients who underwent unilateral traumatic acetabular ORIF during the study period, 36 of whom abused methamphetamines via self-report or toxicology. 104 were excluded for indeterminate abuse histories. INTERVENTION Open Reduction Internal Fixation. MAIN OUTCOME MEASUREMENTS Reoperation resulting from major surgical complications including hematoma, seroma, deep wound infection, failure of fixation, or arthrosis with conversion to arthroplasty. RESULTS Over 10% of our cohort used meth, representing patients who were a mean 8-years younger and sustained a higher rate of high-energy mechanisms than sober peers. Meth abusers had a greater than two-fold reoperation rate at 90 days and one year compared to abstainers (17% versus 7%, and 25% versus 11%, respectively). The adjusted odds ratio (OR) of one-year reoperation in meth users was 3.2 (CI 1.2-8.5, p=0.03). The adjusted one-year survival of native hip after acetabular fractures in meth users approaches 55%. CONCLUSIONS Methamphetamine use is a non-modifiable factor associated with a 3-fold increase in adjusted odds for one-year reoperation after surgical fixation of acetabular fractures. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.