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Poster 125: Cannabis Use Disorder is Not Associated with Opioid Analgesic Use or Patient-Reported Outcomes after Anterior Cruciate Ligament Reconstruction: A Retrospective Matched-Cohort Analysis
OBJECTIVES: Cannabis use disorder (CUD), also known as marijuana use disorder, is prevalent yet underdiagnosed psychiatric condition among the U.S. population. Epidemiologic studies have identified a high rate of comorbidity between CUD and chronic pain and other psychiatric disorders. There is a co...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10392203/ http://dx.doi.org/10.1177/2325967123S00116 |
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author | Buzin, Scott Vasavada, Kinjal Avila, Amanda Strauss, Eric Alaia, Michael Gonzalez-Lomas, Guillem Shankar, Dhruv |
author_facet | Buzin, Scott Vasavada, Kinjal Avila, Amanda Strauss, Eric Alaia, Michael Gonzalez-Lomas, Guillem Shankar, Dhruv |
author_sort | Buzin, Scott |
collection | PubMed |
description | OBJECTIVES: Cannabis use disorder (CUD), also known as marijuana use disorder, is prevalent yet underdiagnosed psychiatric condition among the U.S. population. Epidemiologic studies have identified a high rate of comorbidity between CUD and chronic pain and other psychiatric disorders. There is a concern among orthopedic surgeons that patients with CUD who undergo elective procedures, such as anterior cruciate ligament reconstruction (ACLR), may be at higher risk for long-term opioid use and poorer outcomes following surgery. The aim of this study was to compare opioid use and patient- reported outcomes (PROs) following ACLR between patients with CUD versus controls. METHODS: We conducted a retrospective review of patients with an active diagnosis of CUD who underwent primary ACLR surgery at a single center from 2011-2021 with minimum 3-month follow-up. Patients with CUD were identified using ICD-10 code F12 and its associated sub-codes. CUD patients were matched to controls on age, sex, and follow-up time using greedy nearest-neighbor propensity score matching. Analgesic prescriptions up to one year postoperative were abstracted from medical records and all opioid analgesic doses were converted to morphine milligram equivalents (MMEs). Pre- and post-operative Patient-Reported Outcome Information System (PROMIS) scores, 90-day readmissions, and 90-day revisions were also abstracted from medical records. Outcomes were compared between CUD and control groups using Mann-Whitney U test and Fisher’s exact test. P-values <0.05 were considered significant. RESULTS: 104 CUD patients were matched to 104 controls. Sex demographics were the same in both groups (65.4% male, 34.6% female) and there were no significant differences in mean age (CUD 29.9 vs control 29.2 years; p=0.57), BMI (CUD 25.5 vs control 25.5 years; p=0.95), or follow-up time (CUD 16.1 vs control 15.1 months; p=0.65). Both groups were prescribed postoperative opioids at similar rates (CUD 82.7% vs control 83.7%; p=1.00). Among those prescribed opioids, there were no significant differences in total days supplied (CUD 12.5 vs control 10.8; p=0.67), total MMEs (CUD 558 vs control 445; p=0.71), or MMEs per day (CUD 47.5 vs control 46.3; p=0.65). Likewise, there were no significant differences in pre-to-postoperative improvement in PROMIS Pain Intensity (CUD -5.8 vs control -5.1; p=0.51), Pain Interference (CUD -8.3 vs control -7.6; p=0.81), Mobility (CUD 10.9 vs control 11.1; p=0.90), Mental Health (CUD 0.03 vs control 0.54; p=0.74), or Physical Health (CUD 3.9 vs control 4.2; p=0.94). CONCLUSIONS: Patients with CUD do not appear to consume opioid analgesics at a higher frequency or duration than their counterparts without CUD following ACLR surgery. Furthermore, both groups experience similar improvements in patient-reported outcomes following ACLR and these improvements are not diminished among CUD patients. While orthopedic surgeons should continue to screen patients for cannabis use as part of a thorough preoperative assessment, cannabis abuse or dependence in itself is not cause for concern for worse post-ACLR outcomes. |
format | Online Article Text |
id | pubmed-10392203 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-103922032023-08-02 Poster 125: Cannabis Use Disorder is Not Associated with Opioid Analgesic Use or Patient-Reported Outcomes after Anterior Cruciate Ligament Reconstruction: A Retrospective Matched-Cohort Analysis Buzin, Scott Vasavada, Kinjal Avila, Amanda Strauss, Eric Alaia, Michael Gonzalez-Lomas, Guillem Shankar, Dhruv Orthop J Sports Med Article OBJECTIVES: Cannabis use disorder (CUD), also known as marijuana use disorder, is prevalent yet underdiagnosed psychiatric condition among the U.S. population. Epidemiologic studies have identified a high rate of comorbidity between CUD and chronic pain and other psychiatric disorders. There is a concern among orthopedic surgeons that patients with CUD who undergo elective procedures, such as anterior cruciate ligament reconstruction (ACLR), may be at higher risk for long-term opioid use and poorer outcomes following surgery. The aim of this study was to compare opioid use and patient- reported outcomes (PROs) following ACLR between patients with CUD versus controls. METHODS: We conducted a retrospective review of patients with an active diagnosis of CUD who underwent primary ACLR surgery at a single center from 2011-2021 with minimum 3-month follow-up. Patients with CUD were identified using ICD-10 code F12 and its associated sub-codes. CUD patients were matched to controls on age, sex, and follow-up time using greedy nearest-neighbor propensity score matching. Analgesic prescriptions up to one year postoperative were abstracted from medical records and all opioid analgesic doses were converted to morphine milligram equivalents (MMEs). Pre- and post-operative Patient-Reported Outcome Information System (PROMIS) scores, 90-day readmissions, and 90-day revisions were also abstracted from medical records. Outcomes were compared between CUD and control groups using Mann-Whitney U test and Fisher’s exact test. P-values <0.05 were considered significant. RESULTS: 104 CUD patients were matched to 104 controls. Sex demographics were the same in both groups (65.4% male, 34.6% female) and there were no significant differences in mean age (CUD 29.9 vs control 29.2 years; p=0.57), BMI (CUD 25.5 vs control 25.5 years; p=0.95), or follow-up time (CUD 16.1 vs control 15.1 months; p=0.65). Both groups were prescribed postoperative opioids at similar rates (CUD 82.7% vs control 83.7%; p=1.00). Among those prescribed opioids, there were no significant differences in total days supplied (CUD 12.5 vs control 10.8; p=0.67), total MMEs (CUD 558 vs control 445; p=0.71), or MMEs per day (CUD 47.5 vs control 46.3; p=0.65). Likewise, there were no significant differences in pre-to-postoperative improvement in PROMIS Pain Intensity (CUD -5.8 vs control -5.1; p=0.51), Pain Interference (CUD -8.3 vs control -7.6; p=0.81), Mobility (CUD 10.9 vs control 11.1; p=0.90), Mental Health (CUD 0.03 vs control 0.54; p=0.74), or Physical Health (CUD 3.9 vs control 4.2; p=0.94). CONCLUSIONS: Patients with CUD do not appear to consume opioid analgesics at a higher frequency or duration than their counterparts without CUD following ACLR surgery. Furthermore, both groups experience similar improvements in patient-reported outcomes following ACLR and these improvements are not diminished among CUD patients. While orthopedic surgeons should continue to screen patients for cannabis use as part of a thorough preoperative assessment, cannabis abuse or dependence in itself is not cause for concern for worse post-ACLR outcomes. SAGE Publications 2023-07-31 /pmc/articles/PMC10392203/ http://dx.doi.org/10.1177/2325967123S00116 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc-nd/4.0/This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For article reuse guidelines, please visit SAGE’s website at http://www.sagepub.com/journals-permissions. |
spellingShingle | Article Buzin, Scott Vasavada, Kinjal Avila, Amanda Strauss, Eric Alaia, Michael Gonzalez-Lomas, Guillem Shankar, Dhruv Poster 125: Cannabis Use Disorder is Not Associated with Opioid Analgesic Use or Patient-Reported Outcomes after Anterior Cruciate Ligament Reconstruction: A Retrospective Matched-Cohort Analysis |
title | Poster 125: Cannabis Use Disorder is Not Associated with Opioid Analgesic Use or Patient-Reported Outcomes after Anterior Cruciate Ligament Reconstruction: A Retrospective Matched-Cohort Analysis |
title_full | Poster 125: Cannabis Use Disorder is Not Associated with Opioid Analgesic Use or Patient-Reported Outcomes after Anterior Cruciate Ligament Reconstruction: A Retrospective Matched-Cohort Analysis |
title_fullStr | Poster 125: Cannabis Use Disorder is Not Associated with Opioid Analgesic Use or Patient-Reported Outcomes after Anterior Cruciate Ligament Reconstruction: A Retrospective Matched-Cohort Analysis |
title_full_unstemmed | Poster 125: Cannabis Use Disorder is Not Associated with Opioid Analgesic Use or Patient-Reported Outcomes after Anterior Cruciate Ligament Reconstruction: A Retrospective Matched-Cohort Analysis |
title_short | Poster 125: Cannabis Use Disorder is Not Associated with Opioid Analgesic Use or Patient-Reported Outcomes after Anterior Cruciate Ligament Reconstruction: A Retrospective Matched-Cohort Analysis |
title_sort | poster 125: cannabis use disorder is not associated with opioid analgesic use or patient-reported outcomes after anterior cruciate ligament reconstruction: a retrospective matched-cohort analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10392203/ http://dx.doi.org/10.1177/2325967123S00116 |
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