DOI: 10.1177/23259671261450217 ISSN: 2325-9671

Functional Outcomes After Hip Arthroscopy Based on Self-Reported Cannabis Use: A Matched-Controlled Study

Brandon J. Allen, Jeffrey S. Mun, Srish S. Chenna, Rachel L. Poutre, Jackson G. Woodrow, Rishi P. Earla, Stephen M. Gillinov, Bilal S. Siddiq, Nathan J. Cherian, Chris T. Eberlin, Scott D. Martin
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Background:

There is a paucity of literature investigating the impact of cannabis usage on functional outcomes after primary hip arthroscopy surgery to treat symptomatic labral tears.

Purpose:

To compare patient-reported outcome measures (PROM) for hip arthroscopy patients who did and did not self-report cannabis use, understand how frequency of cannabis use correlates to PROMs, and compare rates of achieving clinically meaningful outcomes for both cohorts.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This was a matched-control cohort study of patients who underwent primary hip arthroscopy for symptomatic labral tears. Included patients were ≥18 years old and completed baseline and 2-year postoperative outcomes surveys. Excluded patients had missing follow-up data, previous ipsilateral hip surgery or revision surgery, and/or hip dysplasia (lateral center-edge angle ≤20°). Patients were retrospectively divided into 2 groups based on whether they were cannabis naive (CN) or cannabis users by reviewing their social history. The 2 groups were then propensity-matched 1:1 by age, sex, body mass index, and Tönnis grade. PROMs were collected prospectively at baseline and 2 years postoperatively. These included the modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sports Specific Subscale, 33-item International Hip Outcome Tool, Lower Extremity Functional Score, and RAND-36 pain subscale (Pain).

Results:

In total, 68 patients were included (aged 31.4 ± 9.67 years). Of these, 34 patients had self-reported cannabis use, and 34 did not report use. All PROM scales were similar at baseline ( P > .05). Cannabis use was not a predictor of functional outcomes at any time point, including the 2-year follow-up for all PROM scales ( P > .05); however, the improvement in Pain scores was significantly better in the CN cohort from baseline to the 2-year follow-up (27.3 ± 28.8 vs 11.6 ± 19.0, P = .012). A linear regression model adjusting for cannabis use frequency found pain scores worsened with increased usage (adjusted mean difference, –2.68; 95% CI, –5.12 to −0.25; P = .031). Further analysis showed no differences in achieving minimal clinically important difference, patient acceptable symptom state, or substantial clinical benefit ( P > .05).

Conclusion:

Self-reported cannabis usage has no impact on raw functional outcomes after hip arthroscopy, but increased usage correlates with worse pain symptoms.

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