Use of Tetrahydrocannabinol and Cannabidiol Products in the Perioperative Period Around Primary Unilateral Total Hip and Knee Arthroplasty.
Given the opioid crisis in America, patients are trying alternative medications including tetrahydrocannabinol (THC) and other cannabidiol (CBD) containing products in the perioperative period, especially in states where these products are legal. This study sought to analyze usage rates of CBDTHC products in the perioperative period for primary unilateral total hip and knee arthroplasty (THATKA) patients and identify a possible association with post-operative opioid use. A prospective cohort of primary unilateral THATKA patients were enrolled at a single institution. Patients who completed detailed pain journals were retrospectively surveyed for CBDTHC product usage. Pain medications were converted to morphine milligram equivalents (MME). Data from 195 of the 210 patients (92.9% response rate) following primary arthroplasty were analyzed. Overall, 16.4% of arthroplasty-22.6% (n 19) of TKA and 11.7% (n 13) of THA-patients used CBDTHC products in the perioperative period. There was a wide variety of usage patterns among those using CBDTHC products. In comparing CBDTHC users and non-users, there was no significant difference in the length of narcotic use, total morphine milligram equivalents taken, narcotic pills taken, average post-op pain scores, the percentage of patients requiring a refill of narcotics, or length of stay. Understanding that CBDTHC usage was not consistent for patients who used these products, 22.6% of TKA and 11.7% of THA patients tried CBDTHC products in the perioperative period. In this small sample, CBDTHC use was not associated with a major effect on narcotic requirements. Further studies on the effects of CBDTHC are needed as these therapies become more widely available.