The Joint EBJIS-MSIS 2026 Conference

Introduction:

Selective serotonin and serotonin-norepinephrine reuptake inhibitors (SSRIs/SNRIs) are commonly used among patients undergoing primary total hip arthroplasty (THA), reflecting the high prevalence of psychiatric comorbidities in this population.

However, the impact of preoperative SSRI/SNRI use on postoperative outcomes following THA remains unclear.

Aim: To evaluate whether SSRI/SNRI use within 6 months before surgery is associated with differences in short- and mid-term postoperative outcomes following primary unilateral THA.

Methods:

A retrospective cohort study using TriNetX Global Database (2010-2024).

The database was reviewed to identify patients who underwent primary unilateral THA (n=141,717) and included patients that have been using SSRI/SNRI within 6 months before surgery (n=21,211), and patients without SSRI/SNRI use (n=120,506).

Propensity score matching done for both the cohorts on age, sex, race, opioid use, depression, anxiety disorders, alcohol use disorders, obesity, nicotine use, diabetes mellitus, and anticoagulant/antithrombotic use.

Outcomes were compared at 90 days, 1 year, and 2 years after THA.

Results:

Overall 15% (21,211/141,717) had a SSRI/SNRI use within 6 months prior to THA.

After propensity score matching, preoperative SSRI/SNRI use was associated with increased 90-days odds of: Sepsis, delirium, PJI, emergency department (ED) visits, opioid prescriptions, readmission, hematoma, transfusion.

At 1-year, SSRI/SNRI use remained associated with increased odds of PJI, hip revision, periprosthetic fracture, opioid prescription and opioid dependence/abuse.

Same associations persisted at 2-years after surgery.

Conclusion:

Preoperative SSRI/SNRI use within 6 months of primary THA was associated with higher rates of short-term complications and worse 1-and 2-year outcomes, such as infection, even after matching for psychiatric comoborbidities, opioid use, and other key patient factors.

Suggest that SSRI/SNRI use may be an important preoperative risk marker for postoperative morbidity following THA.

The Joint EBJIS-MSIS 2026 Conference

SSRI/SNRI Use Within 6 Months Prior to Primary THA Increases Risk of Postoperative Infection and Complications: A Global Database Analysis

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