Cannabis Use Disorder Did Not Worsen Outcomes After ACL Surgery

There were no significant differences between CUD and non-CUD patients in opioid prescription rates (82.7% vs 83.7%), total opioid days supply, total morphine milligram equivalents, or improvement on any of five patient-reported outcome measures (pain intensity, pain interference, mobility, mental health, physical health).

Retrospective matched-cohort study at a single center. 104 patients with CUD who underwent primary ACL reconstruction were propensity-score matched 1:1 to controls on age, sex, and follow-up time. Opioid use was tracked for up to 1 year, and PROMIS instruments assessed outcomes.

There is a common concern that patients with substance use disorders may have worse surgical outcomes or require more pain medication. This study found no evidence to support those concerns for CUD patients undergoing ACL reconstruction.

This adds to a growing body of evidence suggesting that cannabis use disorder alone may not be a reason to alter surgical planning or post-operative care. Stigma around substance use disorders can lead to undertreatment of pain, and data like this can inform more evidence-based decision-making.

Retrospective single-center design. Sample size was not determined a priori, so the study may be underpowered to detect real differences. CUD diagnosis was based on medical records and may not capture all cannabis users. Propensity matching on only three variables may leave residual confounding.