Meta-analysis found cannabis use disorder linked to more complications and higher costs after hip and knee replacements

A meta-analysis of nearly 18 million joint replacement patients found cannabis use disorder was associated with 33% higher medical complications, 75% higher implant complications, and greater financial burden.

Ding, Cheng et al.·The Journal of the American Academy of Orthopaedic Surgeons·2024·Strong EvidenceMeta-Analysis
RTHC-05271Meta AnalysisStrong Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Meta-Analysis
Evidence
Strong Evidence
Sample
Not reported

What This Study Found

Across 10 studies with 17,981,628 participants, CUD was associated with significantly higher odds of medical complications (OR 1.33), implant-related complications (OR 1.75), cardiac complications (OR 1.95), stroke (OR 2.06), infections (OR 1.68), periprosthetic fracture (OR 1.42), mechanical loosening (OR 1.54), and dislocation (OR 1.88). Longer hospital stays and higher costs were also found.

Key Numbers

17,981,628 total participants across 10 studies. Cardiac complications OR 1.95. Stroke OR 2.06. Infections OR 1.68. Periprosthetic fracture OR 1.42. Mechanical loosening OR 1.54. Dislocation OR 1.88. All statistically significant.

How They Did This

Systematic review and meta-analysis searching PubMed, Embase, Scopus, and Web of Science up to July 2018. 10 retrospective cohort studies included. Random effects model used for pooled odds ratios.

Why This Research Matters

Joint replacement is one of the most common elective surgeries. With cannabis use disorder increasing alongside legalization, this meta-analysis quantifies the specific complications orthopedic surgeons should watch for and discuss with patients.

The Bigger Picture

The consistency of increased risk across multiple complication types suggests cannabis use disorder may have systemic effects on surgical recovery, immune function, and bone-implant integration that go beyond the known cardiovascular effects of cannabis.

What This Study Doesn't Tell Us

All included studies were retrospective cohorts. CUD diagnoses likely represent more severe cannabis use, not casual use. Cannot separate CUD effects from polysubstance use or socioeconomic factors. Search limited to July 2018.

Questions This Raises

  • ?What biological mechanisms link cannabis to implant loosening and periprosthetic fracture?
  • ?Does cannabis affect bone healing or immune response around implants?

Trust & Context

Key Stat:
18 million patients; 75% higher implant complications with CUD
Evidence Grade:
Meta-analysis of 10 studies with very large sample, though all component studies were retrospective cohorts.
Study Age:
2024 study
Original Title:
Cannabis Use Disorder Associated With Increased Risk of Postoperative Complications After Hip or Knee Arthroplasties: A Meta-analysis of Observational Studies.
Published In:
The Journal of the American Academy of Orthopaedic Surgeons, 32(20), e1067-e1078 (2024)
Database ID:
RTHC-05271

Evidence Hierarchy

Meta-Analysis / Systematic ReviewCombines many studies into one answer
This study
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Combines results from multiple studies to find an overall pattern.

What do these levels mean? →

Frequently Asked Questions

Does casual cannabis use carry the same risks?

This study focused on cannabis use disorder, which represents a clinical diagnosis of problematic use. Whether casual or infrequent cannabis use carries similar surgical risks is not addressed.

Why might cannabis affect implant outcomes?

The study does not identify specific mechanisms, but cannabis has known effects on inflammation, blood flow, and bone metabolism that could theoretically affect how well implants integrate and heal.

Read More on RethinkTHC

Cite This Study

RTHC-05271·https://rethinkthc.com/research/RTHC-05271

APA

Ding, Cheng; Xu, Dongdong; Cheng, Tao. (2024). Cannabis Use Disorder Associated With Increased Risk of Postoperative Complications After Hip or Knee Arthroplasties: A Meta-analysis of Observational Studies.. The Journal of the American Academy of Orthopaedic Surgeons, 32(20), e1067-e1078. https://doi.org/10.5435/JAAOS-D-23-00407

MLA

Ding, Cheng, et al. "Cannabis Use Disorder Associated With Increased Risk of Postoperative Complications After Hip or Knee Arthroplasties: A Meta-analysis of Observational Studies.." The Journal of the American Academy of Orthopaedic Surgeons, 2024. https://doi.org/10.5435/JAAOS-D-23-00407

RethinkTHC

RethinkTHC Research Database. "Cannabis Use Disorder Associated With Increased Risk of Post..." RTHC-05271. Retrieved from https://rethinkthc.com/research/ding-2024-cannabis-use-disorder-associated

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.