Medicinal Cannabis in Orthopaedic Practice

Kleeman-Forsthuber, Lindsay T.; Dennis, Douglas A.

doi:10.5435/jaaos-d-19-00438

Cited by 21 publications

(21 citation statements)

References 46 publications

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“…In addition, a recent scoping review indicated that cannabis was effective in 67% of studies conducted within orthopaedic populations, 88 but that more high-quality evidence is needed. 89,90 However, a recent systematic review, showed very small improvement in pain, physical functioning, and sleep quality and no effect on emotional well-being when cannabis was used for the treatment of chronic pain. 33 Moreover, the opioid-sparing effects of medical cannabis remain unclear.…”

Section: Dovepressmentioning

confidence: 99%

Pain Management Strategies After Orthopaedic Trauma: A Mixed-Methods Study with a View to Optimizing Practices

Grzelak¹,

Bérubé²,

Gagnon³

et al. 2022

JPR

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To examine 1) pain management strategies within the care trajectory of orthopaedic trauma patients and patients' perception of their effectiveness, 2) adverse effects (AEs) associated with pharmacological treatments, particularly opioids and cannabis, and 3) patients' perceptions of strategies that should be applied after an orthopaedic trauma and support that they should obtain from health professionals for their use. Patients and Methods: This study was conducted with orthopaedic trauma patients in a level 1 trauma center. A convergent mixedmethods design was used. Data on pain experience, pain management strategies used and AEs were collected with self-administered questionnaires at hospital discharge (T1) and at 3 months after injury (T2). Patients' preferences about the pain management strategies used, the required support and AEs were further examined through semi-structured individual interviews at the same time measures. Descriptive statistics and thematic analyses were performed.Results: Seventy-one patients were recruited and 30 individual interviews were undertaken. Pharmacological pain management strategies used at T1 and T2 were mainly opioids (95.8%; 20.8%) and acetaminophen (91.5%; 37.5%). The most frequently applied non-pharmacological strategies were sleep (95.6%) and physical positioning (89.7%) at T1 and massage (46.3%) and relaxation (32.5%) at T2. Findings from quantitative and qualitative analyses highlighted that non-pharmacological strategies, such as comfort, massage, distraction, and physical therapy, were perceived as the most effective by participants. Most common AEs related to opioids were dry mouth (78.8%) and fatigue (66.1%) at T1 and insomnia (30.0%) and fatigue (20.0%) at T2. Dry mouth (28.6%) and drowsiness (14.3%) were the most reported AEs by patients using recreational cannabis. An important need for information at hospital discharge and for a personalized follow-up was identified by participants during interviews. Conclusion: Despite its AEs, we found that opioids are still the leading pain management strategy after an orthopaedic trauma and that more efforts are needed to implement non-pharmacological strategies. Cannabis was taken for recreational purposes but patients also used it for pain relief. Support from health professionals is needed to promote the adequate use of these strategies.

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Section: Dovepressmentioning

confidence: 99%

Pain Management Strategies After Orthopaedic Trauma: A Mixed-Methods Study with a View to Optimizing Practices

Grzelak¹,

Bérubé²,

Gagnon³

et al. 2022

JPR

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“…3,4 Institutions such as the American Academy of Orthopaedic Surgeons have called for further research on cannabis. 5…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Institutions such as the American Academy of Orthopaedic Surgeons have called for further research on cannabis. 5 Several recent scientific investigations have focused on the adverse effects associated with marijuana use. 6 These reports primarily focus on the impact of marijuana on mental health, inflammation, and addiction.…”

Section: Introductionmentioning

confidence: 99%

Marijuana Use Results in Increased Time to Union in Surgically Treated Pediatric Fracture Patients

Heath

Ghali

Momtaz

et al. 2022

Journal of Orthopaedic Trauma

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Objective:To identify the impact of marijuana use on fracture healing in surgically treated pediatric patients.Design:Retrospective review.Setting:Level 1 trauma center, single-center study.Patients/Participants:Surgically treated pediatric patients 10–18 years with extremity fractures from 2010 to 2020. Conservatively treated patients and patients with nonunions were excluded from the study. Three hundred thirty-nine patients were included in the study, 21 of which were confirmed marijuana users by toxicology screening.Intervention:Surgical treatment of extremity fractures by any type of fixation.Main Outcome Measurements:Time to union was the primary outcome and was defined as radiographic evidence of bridging callus on all sides of the fracture and absence of the previous fracture line. Analysis of covariance, logistic regression analysis, and Fisher exact tests were used to establish the relationship between all collected variables and time to radiographic union.Results:The average time to union for marijuana users (159.1 ± 69.5 days, 95% confidence interval) was significantly longer than for nonusers (80.3 ± 7.8 days), P < 0.001. The odds of having a time to union of greater than 4 months and greater than 6 months were 4.17 (P = 0.00192) and 6.19 (P = 0.000159), respectively, for marijuana users compared with nonusers.Conclusion:Marijuana users demonstrated longer time to union in surgically treated pediatric fracture patients.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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“…The recent legalization of cannabis (recreational and/or medicinal) in many states has led to an increase in interest in its potential use for pain management after orthopedic procedures [ [4] , [5] , [6] , [7] , [8] , [9] ]. The self-reported use in patients undergoing TJA increased from 1% to 11% after its legalization in Colorado [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Cannabis may function to reduce sensitization of the nociceptive sensory pathways and induce alterations in cognitive and autonomic processing in selective chronic pain conditions [ 11 , 12 ]. However, the evidence to date does not support its use in patients undergoing orthopedic procedures [ [8] , [9] , [13] , [14] , [15] ]. Therefore, the primary purpose of this prospective study was to determine if cannabis use decreases narcotic consumption in patients undergoing TJA.…”

Section: Introductionmentioning

confidence: 99%

Use of Cannabis Does Not Decrease Opioid Consumption in Patients Who Underwent Total Joint Arthroplasty

McNabb¹,

Johnson

Brady

et al. 2022

Arthroplasty Today

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Medicinal Cannabis in Orthopaedic Practice

Cited by 21 publications

References 46 publications

Pain Management Strategies After Orthopaedic Trauma: A Mixed-Methods Study with a View to Optimizing Practices

Pain Management Strategies After Orthopaedic Trauma: A Mixed-Methods Study with a View to Optimizing Practices

Marijuana Use Results in Increased Time to Union in Surgically Treated Pediatric Fracture Patients

Use of Cannabis Does Not Decrease Opioid Consumption in Patients Who Underwent Total Joint Arthroplasty

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