Purpose
Our purpose is to determine the difference in cost, opioid use, and complication rates
following hip arthroscopy with or without perioperative cannabis use.
Methods
Data were collected from a large commercial insurance database (PearlDiver) between
the years 2010 and 2019. Patients who underwent hip arthroscopy with reported cannabis
use were identified using Common Procedural Terminology codes and the appropriate
International Classification of Diseases codes. This group was then matched by age,
procedure, gender, Charleston Comorbidity Index, Elixhauser Comorbidity Index), obesity,
tobacco use, diabetes to a group of similar patients without self-reported cannabis
use. Opioid use over the episode of care, evaluated by morphine milligram equivalents
(MME), and 30-day cost were compared between groups using unequal variance t-test.
Results
Of queried patients, 360 (.71%) had a diagnosis of preoperative cannabis use, abuse,
or dependence within 5 years prior to their hip arthroscopy. A total of 300 patients
(172 female, 128 male) were matched into each hip arthroscopy group, with and without
cannabis. Of those patients, 171 without cannabis use and 174 with cannabis use had
full financial and opioid use data for analysis. Prescription opioid use was not significantly
different over the episode of care in patients with reported cannabis use (1,840 ±
2,743 MME) than those without reported cannabis use (2,129 ± 3,383 MME) (P = .3848). Additionally, episode of care reimbursement cost following hip arthroscopy
did not differ significantly between patients with cannabis use ($2957 ± $4428) and
those without reported cannabis use ($2,651 ± $3,762) (P = .3620).
Conclusions
Following hip arthroscopy, patients with reported cannabis use do not appear to have
significantly different postoperative opioid use or cost of hip arthroscopy episode
of care compared with patients without reported cannabis use.
Level of Evidence
III, cohort study.
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References
- Health and safety in the legal cannabis industry before and during COVID-19.New Solut. 2021; 30: 311-323
- Cannabis use does not affect outcomes after total knee arthroplasty.J Arthroplasty. 2019; 34: 1667-1669
- 2018 National Surveey on Drug Use and Health: Detailed tables.(2018)https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect1pe2018.htmDate accessed: February 20, 2021
Statista. Resident Population of the United States by Sex and Age as of July 1, 2019. https://www.statista.com/statistics/241488/population-of-the-us-by-sex-and-age/. Accessed April 15, 2021.
Patel J, Marwaha R. Cannabis use disorder. In: StatPearls. Treasure Island, FL: StatPearls Publishing, 2021.
Kane S. ClinCalc Post-hoc Power Calculator. https://clincalc.com/stats/Power.aspx. Accessed June 15, 2021.
- Cannabis use increases risk for revision after total knee arthroplasty.J Long Term Eff Med Implants. 2018; 28: 125-130
- Marijuana use and mortality following orthopedic surgical procedures.Subst Abuse. 2019; 40: 378-382
- Outcomes following primary total hip or knee arthroplasty in substance misusers.J Arthroplasty. 2015; 30: 1137-1141
- Cannabis use disorder and perioperative outcomes in vascular surgery.J Vasc Surg. 2021; 73: 1376-1387.e3
- Medicinal cannabis in orthopaedic practice.J Am Acad Orthop Surg. 2020; 28: 268-277
- Perioperative cannabis use: A longitudinal study of associated clinical characteristics and surgical outcomes.Reg Anesth Pain Med. 2021; 46: 137-144
- Use of tetrahydrocannabinol and cannabidiol products in the perioperative period around primary unilateral total hip and knee arthroplasty.J Arthroplasty. 2020; 35: 138-143
- Comorbid tobacco and other substance use and symptoms of anxiety and depression among hospitalised orthopaedic trauma patients.BMC Psychiatry. 2019; 19: 28
- Orthopaedic surgery patients who use recreational marijuana have less pre-operative pain.Int Orthop. 2019; 43: 283-292
- Preoperative risk factors in hip arthroscopy.Knee Surg Sports Traumatol Arthrosc. 2021; 29: 1502-1509
- National estimates of marijuana use and related indicators: National Survey on Drug Use and Health, United States, 2002-2014.MMWR Surveill Summ. 2016; 65: 1-28
- Cannabinoid and opioid use among total joint arthroplasty patients: A 6-year, single-institution study.Orthopedics. 2021; 44: e101-e106
- Patients who have cannabis use disorder have higher rates of venous thromboemboli, readmission rates, and costs following primary total knee arthroplasty.J Arthroplasty. 2020; 35: 997-1002
- Marijuana's influence on pain scores, initial weight loss, and other bariatric surgical outcomes.Perm J. 2018; 22: 18-1002
- Incidence of drug abuse in revision total knee arthroplasty population.J Knee Surg. 2018; 31: 928-933
- Assessing validity of ICD-9-CM and ICD-10 administrative data in recording clinical conditions in a unique dually coded database.Health Serv Res. 2008; 43: 1424-1441
Article info
Publication history
Published online: January 10, 2022
Accepted:
December 27,
2021
Received:
March 18,
2021
Footnotes
The authors report the following potential conflicts of interest or sources of funding: D.K.W. reports being a consultant for Orthofix and Wright Medical and has received royalties from Arthrex, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
