2023 ISAKOS Biennial Congress ePoster
Cannabis Use Disorder is Not Associated With Opioid Analgesic Use Or Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: A Retrospective Matched-Cohort Analysis
Dhruv Sundar Shankar, BS, New York, New York UNITED STATES
Brittany DeClouette, MD, New York, New York UNITED STATES
Kinjal Vasavada, BA, New York, New York UNITED STATES
Amanda Avila, MPH UNITED STATES
Scott Buzin, DO, New York, NY UNITED STATES
Eric Jason Strauss, MD
Michael J Alaia, MD, New York, New York UNITED STATES
Guillem Gonzalez-Lomas, MD, New York, NY UNITED STATES
NYU Langone Medical Center, New York, New York, UNITED STATES
FDA Status Not Applicable
Summary
Patients with cannabis use disorder (CUD) do not appear to consume opioid analgesics at a higher frequency or duration than their counterparts without CUD following ACLR surgery.
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Abstract
Background
The purpose of this study was to compare opioid analgesic use and patient-reported outcomes (PROs) following anterior cruciate ligament reconstruction (ACLR) between patients with versus without cannabis use disorder (CUD). We hypothesized that patients with CUD would have greater postoperative opioid usage with comparable improvement in PROs.
Methods
We conducted a retrospective matched-cohort study involving patients with CUD who underwent primary ACLR at a single center and had minimum 3-month follow-up. CUD patients were propensity score matched 1:1 to non-CUD controls with respect to age, sex, and follow-up time. Total refills, days supply, and morphine milligram equivalents (MMEs) of opioid analgesics prescribed were calculated for up to one year postoperative. Patient-Reported Outcome Information System (PROMIS) instruments were used to assess PROs. Opioid use and 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. Both groups were majority male (65.4% male, 34.6% female). The CUD group had mean age of 29.9 years and mean follow-up time of 16.1 months. There was no significant inter-group difference in opioid prescription rates (CUD 82.7% vs. control 83.7%, p=1.00). Among patients prescribed opioids, there were no significant inter-group differences in total days supply (p=0.67), total MMEs (p=0.71), or MMEs per day (p=0.65). There were no significant differences in pre-to-postoperative improvement in PROMIS Pain Intensity (p=0.51), Pain Interference (p=0.81), Mobility (p=0.90), Mental Health (p=0.74), or Physical Health (p=0.94).
Conclusion
There are no significant differences in opioid usage or PRO improvement following ACL reconstruction between patients with CUD and those without.