Abstract
Purpose
The efficacy of cannabis (THC, CBD) for pain management remains uncertain with limited evidence in patients undergoing arthroscopic surgery. The aim of this study was to quantify prevalence of self-reported cannabis use within the population of adults undergoing hip arthroscopy and investigate the potential association of cannabis use and immediate post-operative pain in this patient population.
Methods
Following IRB approval, adult patients undergoing hip arthroscopy between January 1, 2023, and December 31, 2023.were identified at a high-volume orthopedic specialty hospital in a state where adult cannabis use has been legalized. Demographic variables (age, sex, race/ethnicity), any drug-use reported by the patient pre-operatively, procedures undergone, and NRS pain scores (0-10, 10 is worst) in the post-anesthesia care unit (PACU) were extracted. Paired t-tests were performed for continuous variables to assess differences in patients reporting vs not reporting cannabis use. Chi Square tests were utilized for categorical variables.
Results
Among 668 patients identified, 19.3% reported cannabis use pre-operatively. The mean age of the cohort was 36.17 years (SD 15.21) and 53.1% (n = 355) male. A significantly higher proportion of cannabis users were male (p < 0.001). Patients self-reporting cannabis use were also significantly older compared to non-users (45.16 years v. 34.04 years, p < 0.0001). Across both groups, most patients underwent labral repair as their primary procedure (90.1%, n = 602). There was no significant difference in anesthetic method between groups (regional anesthesia, neuraxial block) (p = 0.219). PACU pain scores were significantly higher among cannabis users (6.44) compared to non-users (5.86) (p = 0.018).
Discussion
There is a relatively high prevalence of THC use in our study population. Patients using THC are significantly older and more likely to be male compared to those who do not report cannabis use. Additionally, patients using THC pre-operatively demonstrated significantly increased perioperative pain scores. Further investigation is warranted to determine clinical relevance of cannabis use on pain outcomes in sports medicine and hip preservation. THC screening may be useful for identifying patients with heightened postoperative pain control needs.