Up to two years following elective, arthroscopic hip surgery, a substantial proportion of patients reported troubling new health issues ranging from sleep problems to arthritis to cardiovascular disease.

While such problems can be transient and diminish as full mobility returns, the findings suggest that patients and doctors should be prepared to manage a variety of complications over time, even as the surgeries themselves are considered a success.

“Our study focused on a younger group—current and former military personnel ages 18-50—and compared their medical records both before and after surgery,” says Daniel Rhon, DSc, an adjunct professor at the Duke Clinical Research Institute (DCRI) and lead author of a study published online Sept 28 in the British Journal of Sports Medicine.

“Even among this younger group, the number and frequency of these hidden complications that arose after elective hip surgery suggests we should be taking a more wholistic approach, proactively assessing patients for risks other than the standard surgical complications we more commonly look for,” Rhon says in a release.

Rhon and colleagues—including senior author Chad Cook, PhD, program director of Duke’s doctor of physical therapy program and member of the DCRI—conducted the observational study by examining Military Health System records of 1,870 former and current service members undergoing arthroscopic hip surgery between 2004-2013. Patient records were collected for the 12 months prior to and 24 months after surgery.

In their analysis, they identified incidences of mental health disorders, chronic pain, substance abuse issues, cardiovascular ailments, metabolic syndrome, arthritis, and sleep problems that were noted in the patients’ medical records both before and after their elective hip surgeries.

Post-surgery incidences of all comorbidities after the procedure rose dramatically. Mental health disorder increased 84%. Chronic pain diagnoses soared 166%. Substance abuse ticked up 57%. Cardiovascular disorders rose 71%. Metabolic syndrome cases rose 86%. Arthritis spiked 132%. Sleep disorders jumped 111%.

“Hip arthoscopy is becoming more common even among younger people, and it can be quite successful in resolving chronic, painful conditions,” Cook says. “But it’s important to be prepared for a lengthy recovery. These are surgeries where people are prohibited from fully bearing weight for several weeks, so they can’t exercise, they can’t sleep comfortably, they are in pain.”

Rhon says disruptions in sleep can be particularly problematic. Without proper rest, the sense of pain escalates, leading to a negative spiral of fatigue and pain that then depresses mood, energy levels, and general health.

“These issues are compounding on each other,” Rhon says. “Our study serves as an important alert to both doctors and patients. Armed with this knowledge, we can be vigilant in addressing these problems earlier and potentially stopping others from developing.”

In addition to Rhon and Cook, study authors include Tina Greenlee, Bryant Marchant, and Charles D. Sissel.

The research received support from the US Defense Health Agency.