Orthopaedic surgery patients who use recreational marijuana have less pre-operative pain



To determine the baseline clinical characteristics of recreational marijuana users undergoing outpatient orthopaedic surgery. We hypothesized that patients who report marijuana use would have worse pain, function, and general health status.

Patients and methods

Nine-hundred and thirty-seven patients undergoing outpatient orthopaedic surgery were asked to fill out patient-reported outcome (PRO) tools. These PROs included the Patient-Reported Outcomes Measurement Information Systems (PROMIS) computer adaptive tests and legacy PROs unique to each patients’ surgical site.


Forty patients (4.2%) reported marijuana use. Marijuana use was associated with younger age (33 vs. 43 years, p < 0.001), having a history of fewer operations (1.8 vs. 3.2, p < 0.05), single marital status (68 vs. 38%, p < 0.01), and having a history of smoking cigarettes (63 vs. 31%, p < 0.0001). Marijuana use was found to be significantly associated with greater Marx lower extremity activity rating scale scores (8.5 points vs. 6.1 points, p < 0.05) and decreased pain intensity in the operative site (3.7 points vs. 5.0 points, p < 0.05). Multivariable analysis found that marijuana use was an independent factor associated with less pain intensity in the operative site (p < 0.05).


Our studies support other national studies that report increased marijuana use among younger patients and those who smoke cigarettes. The results do not support our hypothesis, as marijuana use was associated with less pain and better lower extremity activity rating scale scores when compared to non-users. Further research is warranted to analyze the effects of marijuana use on orthopaedic surgery patients.

Study design

Cross-sectional study.

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This work was supported by a grant from The James Lawrence Kernan Hospital Endowment Fund, Incorporated.

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Correspondence to R. Frank Henn III.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.


This study was approved by the Institutional Review Board (IRB) Committee at the University of Maryland, Baltimore (HP-00062261).

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Medina, S.H., Nadarajah, V., Jauregui, J.J. et al. Orthopaedic surgery patients who use recreational marijuana have less pre-operative pain. International Orthopaedics (SICOT) 43, 283–292 (2019). https://doi.org/10.1007/s00264-018-4101-x

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  • Marijuana
  • Orthopaedic surgery
  • Clinical characteristics
  • Substance use