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Cannabis Use Disorder in the Setting of Primary Total Hip Arthroplasty: Understanding the Epidemiology, Demographic Characteristics, and Inpatient Postoperative Outcomes

Abdul K. Zalikha, Dalia Rahmon, Matthew Mazur, Inaya Hajj Hussein, Mouhanad M. El‐Othmani

2022Journal of the American Academy of Orthopaedic Surgeons17 citationsDOI

Abstract

INTRODUCTION: Cannabis use is expected to increase in the context of its decriminalization and legalization in several states. The purpose of this study was to report on the epidemiologic and demographic characteristics and inpatient postoperative outcomes of patients with cannabis use disorder (CUD) undergoing primary total hip arthroplasty (THA). METHODS: The National Inpatient Sample registry was used to identify patients undergoing THA between 2006 and 2015. Patients were stratified into groups with and without CUD. Epidemiology, comorbidity, and outcomes data were comparatively analyzed between these two groups. RESULTS: A total of 2,838,742 THAs were performed during the study period. The prevalence of CUD significantly increased from 0.10% in 2006 to 0.39% in 2015 (P < 0.0001). Patients with CUD were significantly younger, more likely to be male, had higher rates of Medicaid insurance and were more likely to be non-Hispanic Black and less likely to be non-Hispanic White when compared with the control group. When comparing patients with and without CUD, there was no significant difference in the composite any complication variable and no significant difference in seven of eight individual in-hospital complications assessed, with the exception being higher genitourinary complications in the CUD group. There were no significant differences in discharge disposition or length of stay. DISCUSSION: Although CUD is significantly associated with various demographic, comorbidity, and hospital characteristics, it is not significantly associated with in-hospital complications, discharge disposition, and length of stay outcomes in the immediate in-hospital, postoperative period. It is critical for clinicians and public health professionals to understand the characteristics and expected inpatient outcomes of this evolving population of patients with CUD undergoing THA, particularly in the context of widespread legalization. LEVEL OF EVIDENCE: Level III.

Topics & Concepts

MedicineComorbidityMedicaidContext (archaeology)EpidemiologyEmergency medicineArthroplastyInternal medicineSurgeryHealth careEconomicsBiologyEconomic growthPaleontologyCannabis and Cannabinoid ResearchSubstance Abuse Treatment and OutcomesOpioid Use Disorder Treatment