Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York, USA.
Department of Orthopaedic Surgery, Northwell Health, Lenox Hill Hospital, New York, New York, USA.
Bone Joint J. 2021 Jul;103-B(7 Supple B):111-115. doi: 10.1302/0301-620X.103B7.BJJ-2020-2424.R1.
Although there is increasing legalization of the use of cannabis in the USA, few well-powered studies have evaluated the association between cannabis use disorder and outcomes following primary total hip arthroplasty (THA). Thus, the aim of this study was to determine whether patients who use cannabis and undergo primary THA have higher rates of in-hospital length of stay (LOS), medical complications, implant-related complications, and costs.
Using an administrative database, patients with cannabis use disorder undergoing primary THA were matched to a control group in a 1:5 ratio by age, sex, and various medical comorbidities. This yielded 23,030 patients (3,842 in the study group matched with 19,188 in the control group). The variables which were studied included LOS, 90-day medical complications, two-year implant-related complications, and 90-day costs of care. Mann-Whitney U tests were used to compare LOS and costs. Multivariate logistic regression analyses were used to calculate the odds ratios (ORs) of developing complications.
We found that patients in the study group had a significantly longer mean LOS compared with the controls (four days vs three days; p < 0.0001).The study group also had a significantly higher incidence and odds of developing medical (23.0 vs 9.8%, OR 1.6; p < 0.0001) and implant-related complications (16 vs 7.4%, OR 1.6; p < 0.0001) and incurred significantly higher mean 90-day costs ($16,938.00 vs $16,023.00; p < 0.0001).
With the increasing rates of cannabis use, these findings allow orthopaedic surgeons and other healthcare professionals to counsel patients with cannabis use disorder about the possible outcomes following their THA, with increased hospital stays, complications, and costs. Cite this article: 2021;103-B(7 Supple B):111-115.
尽管美国越来越多地将大麻使用合法化,但很少有强有力的研究评估大麻使用障碍与初次全髋关节置换术(THA)后结果之间的关系。因此,本研究旨在确定使用大麻并接受初次 THA 的患者是否具有更高的住院时间(LOS)、医疗并发症、与植入物相关的并发症和费用发生率。
使用行政数据库,通过年龄、性别和各种合并症,将患有大麻使用障碍的患者与初次 THA 进行 1:5 的匹配,共产生 23030 名患者(研究组 3842 例,对照组 19188 例)。研究的变量包括 LOS、90 天医疗并发症、两年与植入物相关的并发症和 90 天护理费用。采用 Mann-Whitney U 检验比较 LOS 和费用。采用多变量逻辑回归分析计算并发症发生的优势比(OR)。
我们发现研究组患者的平均 LOS 明显长于对照组(四天 vs 三天;p < 0.0001)。研究组发生医疗(23.0% vs 9.8%,OR 1.6;p < 0.0001)和与植入物相关的并发症(16% vs 7.4%,OR 1.6;p < 0.0001)的发生率和比值也明显更高,90 天平均费用也明显更高($16938.00 美元 vs $16023.00 美元;p < 0.0001)。
随着大麻使用率的增加,这些发现使矫形外科医生和其他医疗保健专业人员能够向患有大麻使用障碍的患者提供有关他们接受 THA 后可能出现的结果的咨询,包括住院时间延长、并发症和费用增加。