Patients coded for marijuana use had significantly higher rates of hip dislocation within 90 days and one year of total hip replacement, though opioid use after surgery was no different.
Orthopedic surgeons, perioperative care teams, patients preparing for hip replacement
What the researchers found
Among 1,654 matched pairs of marijuana users and non-users who underwent total hip arthroplasty (2010-2018), marijuana users had significantly higher rates of hip dislocation at both 90 days and one year. However, there was no difference in opioid consumption between groups. Marijuana use was associated with lower 90-day care costs.
Why it matters
The finding that marijuana use did not increase opioid consumption challenges the common assumption that cannabis users need more pain medication postoperatively. The dislocation finding may relate to balance or coordination effects rather than surgical healing.
The numbers in context
1,654 matched patients per group; higher hip dislocation rates at 90 days and 1 year; no difference in opioid consumption; lower 90-day costs for marijuana users
How the study worked
Retrospective review of the Mariner insurance database (2010-2018). Marijuana users identified by ICD codes were 1:1 matched to non-users on age, sex, comorbidities, obesity, alcohol, tobacco, illicit drug use, drug abuse history, and psychiatric history. Compared 90-day and 1-year outcomes.
What this study cannot tell us
Administrative database with ICD coding for marijuana use likely captures only diagnosed cannabis use disorder. Cannot distinguish active use from historical use. Cannot control for factors not captured in claims data. Dislocation mechanism not specified.
How to read the evidence
Moderate: large matched cohort from insurance database, but limited by ICD coding accuracy and inability to assess active use patterns.
When this study was published
2025 publication using 2010-2018 data
The bigger picture
This adds to the surgical outcomes literature showing cannabis-associated complications that may relate to physical function (falls, coordination) rather than wound healing or infection.
Questions still open
- Is the dislocation risk related to balance/coordination impairment or another mechanism?
- Would preoperative counseling about fall prevention reduce dislocation rates in cannabis users?
Read the original research
Marijuana Use Is Associated with Increased Rates of Hip Dislocation and Lower Insurance Reimbursement among Total Hip Arthroplasty Recipients.
Journal of long-term effects of medical implants, 35(1), 17-23
Citation
Gwam, Chukwuweike; Kelly, Erin; Douglas, Scott; Recker, Andrew; Plate, Johannes F. (2025). Marijuana Use Is Associated with Increased Rates of Hip Dislocation and Lower Insurance Reimbursement among Total Hip Arthroplasty Recipients.. Journal of long-term effects of medical implants, 35(1), 17-23. https://doi.org/10.1615/JLongTermEffMedImplants.2024049017
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