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Preoperative cannabis use does not increase opioid utilization following primary total hip arthroplasty in a propensity matched analysis

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

The recreational and medical use of cannabis is being legalized worldwide. Its use has been linked to an increased risk of developing opioid use disorders. As opioids continue to be prescribed after total hip arthroplasty (THA), the influence that preoperative cannabis use may have on postoperative opioid consumption remains unknown. The purpose of this study was to assess the relationship between preoperative cannabis use and opioid utilization following primary THA.

Methods

We identified all patients over the age of 18 who underwent unilateral, primary THA for a diagnosis of osteoarthritis at a single institution from February 2019 to April 2021. Our cohort was grouped into current cannabis users (within 6 months of surgery) and those who reported never using cannabis. One hundred and fifty-six current users were propensity score matched 1:6 with 936 never users based on age, sex, BMI, history of chronic pain, smoking status, history of anxiety/depression, ASA classification and type of anesthesia. Outcomes included inpatient and postdischarge opioid use in morphine milligram equivalents.

Results

Total inpatient opioid utilization, opioids refilled, and total opioids used within 90 postoperative days were similar between the groups.

Conclusion

In propensity score matched analyses, preoperative cannabis use was not independently associated with an increase in inpatient or outpatient, 90-days opioid consumption following elective THA.

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Acknowledgements

This study was funded by the generous donations of  Mr. Kim Davis and Mr. Baryn Futa. We are grateful to the members of the HSS ARJR Perioperative Outcomes Group who contributed to the design of this study and to the surgeons of the ARJR Service who contributed patients to this study.

Funding

Author Alejandro Gonzalez Della Valle received research support from company Naviswiss. This research was partially funded by donations from Mr. Kim Davis and Mr. Baryn Futa. Myself and my co-authors have the following disclosures to report: Author Alejandro Gonzalez Della Valle received royalties from company Orthodevelopment-Stryker. Author Alejandro Gonzalez Della Valle is a paid consultant for companies Link Bio, Johnson and Johnson and Naviswiss.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Christian B. Ong, Simarjeet Puri, Juliana Lebowitz, Alejandro Gonzalez Della Valle, Alexandra Sideris & Brian P. Chalmers

  2. Department of Biostatistics, Hospital for Special Surgery, New York, NY, USA

    Yu-Fen Chiu

Authors
  1. Christian B. Ong
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  2. Simarjeet Puri
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  4. Yu-Fen Chiu
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  5. Alejandro Gonzalez Della Valle
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  6. Alexandra Sideris
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  7. Brian P. Chalmers
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by CO. Data analysis was performed by Y-FC. The first draft of the manuscript was written by CO and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Brian P. Chalmers.

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The authors declare that they have no relevant conflicts of interest to disclose.

Ethical approval

The methodology for this study was approved by the Human Research Ethics Committee/Institutional Review Board of our institution.

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Informed consent was obtained from all individual participants included in this study.

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The authors affirm that human research participants provided informed consent for publication of their deidentified medical data.

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Ong, C.B., Puri, S., Lebowitz, J. et al. Preoperative cannabis use does not increase opioid utilization following primary total hip arthroplasty in a propensity matched analysis. Arch Orthop Trauma Surg 143, 3629–3635 (2023). https://doi.org/10.1007/s00402-022-04619-7

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  • DOI: https://doi.org/10.1007/s00402-022-04619-7

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