Patient-reported cannabis use had no effect of outcomes, opioid use 1 year after THA
Click Here to Manage Email Alerts
Key takeaways:
- Patient-reported cannabis use had no effect on 1-year outcomes after THA.
- Cannabis users had similar functional outcomes, opioid consumption, length of stay, readmission or reoperation vs. non-users.
Published results showed patient-reported cannabis use had no effect on functional outcomes, opioid consumption, length of stay, readmission or reoperation at 1 year after total hip arthroplasty.
Researchers retrospectively analyzed data from 74 patients who self-reported cannabis use and underwent primary THA from Jan. 1, 2014, to Nov. 30, 2019, at a single institution with a minimum follow-up of 1 year. Researchers also analyzed a matched cohort of 74 patients who did not self-report cannabis use.
Outcome measures included Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score for Joint Reconstruction (HOOS JR), morphine milligram equivalents (MMEs) consumed in the hospital, outpatient MMEs prescribed, length of stay (LOS), readmissions and reoperations.
Mean change in HHS was 34.1 in the cannabis group and 33.5 in the control group. Mean changes in HOOS JR scores were also similar between the cannabis group (31.5) and the control group (31.9).
Mean inpatient MMEs consumed were 102.4 for the cannabis group and 101 for the control group, while mean outpatient MMEs prescribed were 119.7 for the cannabis group and 156 for the control group.
Mean LOS was 1.4 days in the cannabis group and 1.5 days in the control group, while readmission and reoperation rates were also similar between the groups.
“This information may be helpful for orthopedic surgeons counseling patients who require THA and are interested in perioperative cannabis use,” the researchers wrote in the study. “As cannabis becomes more widely available and patient interest in its use continues to increase, further research with higher quality, longer-term prospective studies are required to determine its efficacy and safety as part of a perioperative pain management protocol,” they concluded.
Perspective
Back to Top
As more U.S. states legalize cannabis for medical and recreational use, there's a notable shift in consumption trends. With medical cannabis legal in 37 states and approximately 18% of the U.S. population using cannabis in 2020, a new unknown emerges for orthopedic surgeons and their patients.
In this study by Vishal Hegde, MD, and colleagues, the authors examined the impact of self-reported cannabis use on THA outcomes in 74 patients. The results showed no significant differences between cannabis users and non-users in terms of hip function, pain scores, opioid consumption, hospital stay, complications, readmissions or reoperations after 1 year, suggesting that cannabis use does not appear to affect short-term THA outcomes.
To date, the largest meta-analysis on this topic by Oguz A. Turan, MS, and colleagues found that cannabis may be associated with an increased risk of surgical revisions, pneumonia and cerebrovascular accidents in THA. Notably, cannabis use did not affect pain levels or opioid consumption.
Still, it is important to note a significant limitation on this topic: The variability in the quality, quantity and method of cannabis consumption across the studies analyzed is underreported. Most studies do not provide specific details about the type of cannabis, the amount used or the method of intake, making it impossible to establish a dose-response relationship between cannabis and adverse effects or pain. Therefore, future higher-level studies are needed to ascertain the impact of cannabis use for patients undergoing THA.
Reference:
Turan OA, et al. J Arthroplasty. 2023;doi:10.1016/j.arth.2023.07.008.
Collapse
Read more about
Click Here to Manage Email Alerts