Self-Reported Cannabis Use Is Associated With a Lower Rate of Persistent Opioid Use After Total Joint Arthroplasty

Vishal Hegde, MD; Daniel N. Bracey, MD, PhD; Roseann M. Johnson, BS, CCRP; Yasmin Yazdani Farsad, BS; Douglas A. Dennis, MD; Jason M. Jennings, MD, DPT

Arthroplasty Today (Oct 2022)

Self-Reported Cannabis Use Is Associated With a Lower Rate of Persistent Opioid Use After Total Joint Arthroplasty

Vishal Hegde, MD,
Daniel N. Bracey, MD, PhD,
Roseann M. Johnson, BS, CCRP,
Yasmin Yazdani Farsad, BS,
Douglas A. Dennis, MD,
Jason M. Jennings, MD, DPT

Affiliations

Vishal Hegde, MD: Colorado Joint Replacement, Denver, CO, USA; Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA
Daniel N. Bracey, MD, PhD: Colorado Joint Replacement, Denver, CO, USA; Department of Orthopaedic Surgery, University of North Carolina, Chapel Hill, NC, USA
Roseann M. Johnson, BS, CCRP: Colorado Joint Replacement, Denver, CO, USA
Yasmin Yazdani Farsad, BS: Colorado Joint Replacement, Denver, CO, USA
Douglas A. Dennis, MD: Colorado Joint Replacement, Denver, CO, USA; Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, USA; Department of Orthopaedics, University of Colorado School of Medicine, Aurora, CO, USA; Department of Biomedical Engineering, University of Tennessee, Knoxville, TN, USA
Jason M. Jennings, MD, DPT: Colorado Joint Replacement, Denver, CO, USA; Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, USA; Corresponding author. Colorado Joint Replacement, 2535 S Downing St. Suite 100 Denver, CO 80210, USA. Tel.: +1 303 260 2940.

Journal volume & issue: Vol. 17
pp. 145 – 149

Abstract

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Background: Legalization of cannabis, along with concern over prescription opiate use, has garnered interest in cannabis for adjuvant pain control. This study examines the relationship between cannabis and opioid consumption after total hip (THA) or knee (TKA) arthroplasty. Methods: Patients undergoing primary THA or TKA with minimum 6-month follow-up who self-reported cannabis use were retrospectively reviewed. A total of 210 patients (128 TKAs and 82 THAs) were matched by age; gender; type of arthroplasty; Charlson Comorbidity Index; and use of nicotine, antidepressants, or benzodiazepines to patients who did not self-report cannabis use. Patients receiving an opioid prescription after 90 days postoperatively were classified as persistent opioid users (POUs). Duration of opioid use (DOU) was calculated for non-POU patients as the time between surgery and their last opioid prescription. Differences in inpatient morphine milligram equivalents (MMEs), outpatient MMEs, POU, and DOU were analyzed. Results: Cannabis users required equivalent inpatient and outpatient MMEs. There was no difference in DOU. There was a significant difference in POU between cannabis users and matched controls (1.4% [n = 3] vs 9.5% [n = 20], P < .001, respectively). Grouping patients by TKA or THA, there remained a difference in POU for TKA (1.5% [n = 2] vs 10.9% [n = 14], P = .002) and THA (1.2% [n = 1] vs 7.3% [n = 6], P = .04). There was no difference in inpatient or outpatient MMEs or DOU for THA and TKA patients. Conclusions: There is a reduced rate of POU in patients who self-report perioperative cannabis use. Prospective studies are needed to clarify the role of cannabis as an adjunct to perioperative pain control.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

About the journal

Abstract

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