The Association of Cannabis Use Disorder and Perioperative Complications After Primary Total Knee Arthroplasty

J Am Acad Orthop Surg. 2022 Apr 1;30(7):313-320. doi: 10.5435/JAAOS-D-21-00703.

Abstract

Introduction: Although studies have shown the implications of substance use on total joint arthroplasty, studies investigating the association of patients exclusively who have cannabis use disorder (CUD) after primary total knee arthroplasty (TKA) are sparse. As such, this study analyzed a private payor database to assess the relationship of CUD after primary TKA.

Methods: Data from the Mariner data set were used to identify patients who have CUD undergoing primary TKA. Patients with CUD were ratio matched 1:5 to a comparison population by age, sex, and comorbidities, yielding 55,553 patients in the study (n = 9,260) and case-matched (n = 46,293) population. Variables compared included in-hospital length of stay, complications, and costs. A P value of less than 0.003 was considered statistically significant.

Results: Patients with CUD were found to have longer in-hospital length of stay (3.61 versus 2.07 days, P < 0.0001), in addition to higher frequency and odds ratio (OR) of medical (28.08 versus 12.5; OR, 1.50, P < 0.0001) and prostheses-related complications (9.63 versus 5.16%; OR, 1.56, P < 0.0001). Patients with CUD also incurred significantly higher episode of care costs ($29,025.34 versus $24,258.17, P < 0.0001).

Conclusion: With the continued legalization of cannabis use across the United States, studies investigating the association of cannabis on outcomes after primary TKA are limited. The current study helps to expand the current literature on outcomes of substance abuse after total joint arthroplasty and can serve to help educate patients of potential complications after their TKA.

MeSH terms

  • Arthroplasty, Replacement, Hip* / adverse effects
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Humans
  • Length of Stay
  • Marijuana Abuse* / complications
  • Marijuana Abuse* / epidemiology
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Risk Factors
  • United States