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Updated: Oct 21, 2025

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Methamphetamines and Acetabular Reoperation Rates: Poor Outcomes From the Front Lines.

Natalie L Zusman¹, Erik Woelber, Natasha S McKibben

¹Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR.

Journal of Orthopaedic Trauma

|September 1, 2021

Summary

Methamphetamine (meth) abuse significantly increases the risk of reoperation after acetabular fracture surgery. Patients who used meth had more than double the reoperation rate within one year compared to abstainers.

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Area of Science:

Orthopedic surgery
Trauma surgery
Substance abuse research

Background:

Acetabular fractures are complex injuries requiring surgical intervention.
The impact of methamphetamine abuse on surgical outcomes for acetabular fractures is not well-established.

Purpose of the Study:

To compare the 1-year reoperation rates in patients who underwent acetabular fracture surgery.
To investigate the association between methamphetamine abuse and reoperation after acetabular fracture fixation.

Main Methods:

Retrospective database analysis of 371 patients undergoing open reduction internal fixation for acetabular fractures from 2008-2018.
Patients were categorized into methamphetamine abusers and abstainers based on self-report or toxicology.
Reoperation outcomes were assessed for major surgical complications within 1 year.

Main Results:

Over 10% of the cohort were methamphetamine users, younger on average and with higher rates of high-energy mechanisms.
Methamphetamine abusers exhibited more than a 2-fold increased reoperation rate at 90 days and 1 year (25% vs. 11%).
Adjusted odds of 1-year reoperation were 3.2 times higher in methamphetamine users (P=0.03), with native hip survival approaching 55%.

Conclusions:

Methamphetamine use is a significant, nonmodifiable factor associated with increased reoperation rates after acetabular fracture surgery.
The findings highlight the importance of considering substance abuse history in managing patients with acetabular fractures.
Methamphetamine abuse is linked to a threefold increase in adjusted odds for 1-year reoperation.