Abstract
Background: Total knee arthroplasty (TKA) is a very common orthopedic procedure and with legalization of cannabis in many states, orthopedic surgeons are frequently encountering patients undergoing TKA with preoperative cannabis use disorder. There is conflicting and limited evidence on the impact of preoperative cannabis use and postoperative outcome.Methods and materials: In this study we retrospectively reviewed PearlDiver insurance database and analyzed the characteristics of the cannabis use in TKA patients and the impact of preoperative diagnosis of cannabis use disorder on postoperative risk of manipulation under anesthesia (MUA) within one year and revision risk within two years. We compared our results to a matched sample of opioid use patients and standard TKA patients.Result: Our study shows that cannabis use disorder was found in less than 1% of the patients undergoing total knee replacement. We identified 278 patients with cannabis use disorder undergoing TKA. More than 90% of the patients are between 40 to 69 years. There was no statistically significant gender difference noted with 130 males and 148 females. Matching sample analysis showed that the risk of MUA and risk of revision in these cannabis use patients are comparable to standard knee replacement patients and in TKA patients taking preoperative opioids.Conclusion: Retrospective database review failed to identify any increased risk of MUA or two-year revision in cannabis use TKA patients.
Highlights
More than 30 states have legalized the medical use of marijuana and several states have legalized the recreational use of cannabis [1]
The aim of this study was to evaluate the risk of revision and manipulation under anesthesia following Total knee arthroplasty (TKA) in patients with preoperative cannabis use disorder compared to patients with preoperative opioid use in a large database population
Almost 92% of the TKA patients using cannabis were between the ages of 45 and 69 years, and more than 50% of users were between 50 and 59 years old
Summary
More than 30 states have legalized the medical use of marijuana and several states have legalized the recreational use of cannabis [1]. A recent survey of 43 million people in United States showed that nearly 16% have reported using some form of cannabis at least once in the last year. Another 1.6% has reported cannabis dependence disorder [2,3]. Total knee arthroplasty (TKA) is one of the most commonly performed orthopedic procedures, and there is conflicting and limited data about cannabis use in TKA patients. Total knee arthroplasty (TKA) is a very common orthopedic procedure and with legalization of cannabis in many states, orthopedic surgeons are frequently encountering patients undergoing TKA with preoperative cannabis use disorder. There is conflicting and limited evidence on the impact of preoperative cannabis use and postoperative outcome
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