THC/CBD combinations showed modest opioid-sparing potential after orthopedic surgery, but CBD alone had mixed results | Research

The takeaway

A scoping review of 14 studies found THC/CBD combinations showed modest potential for reducing opioid use after orthopedic surgery with neutral safety profiles, while CBD-only interventions had inconsistent results.

Orthopedic surgeons, pain management specialists, and patients concerned about postoperative opioid use.

THC/CBD combinations: modest opioid-sparing; CBD alone: mixed results

What the researchers found

CBD-only interventions showed mixed results for post-orthopedic surgical pain. THC/CBD combinations demonstrated modest potential for opioid-sparing effects with neutral safety profiles. One THC-only study reported increased opioid use and longer hospital stays, though confounders were present.

Why it matters

Opioid dependence after orthopedic surgery is a major clinical problem. Understanding which cannabinoid formulations might help reduce opioid use postoperatively is crucial, especially given the heterogeneity in available evidence.

The numbers in context

14 experimental studies included. Three categories: CBD-only (mixed results), THC-only (1 study, worse outcomes), THC/CBD combination (modest opioid-sparing). Overall evidence limited by heterogeneous study designs.

How the study worked

Scoping review of experimental studies published from 2014 to 2025 investigating cannabis or CBD for postoperative orthopedic pain management. Fourteen studies met inclusion criteria, categorized by cannabinoid composition (CBD only, THC only, or THC/CBD combination).

What this study cannot tell us

Only 14 studies, with heterogeneous designs, formulations, dosing, and patient populations. Scoping review methodology does not assess study quality. Most studies were small. Results cannot be generalized across orthopedic procedure types.

How to read the evidence

Preliminary: scoping review of heterogeneous studies with varied designs, formulations, and outcomes preventing firm conclusions.

When this study was published

Published 2026. Studies from 2014 to 2025.

The bigger picture

The finding that THC/CBD combinations may be more promising than CBD alone aligns with the broader trend in cannabinoid research suggesting that multi-cannabinoid approaches outperform single-compound interventions.

Questions still open

What THC:CBD ratios are most effective for postoperative pain? Should cannabinoids be started preoperatively or postoperatively? Would standardized study designs resolve the inconsistency in CBD-only results?

Common questions

Can cannabis reduce opioid use after orthopedic surgery?

THC/CBD combinations showed modest potential for reducing opioid use with acceptable safety, but CBD alone had inconsistent results. More standardized research is needed.

Is CBD effective for postoperative pain?

Results were mixed. CBD-only interventions did not consistently reduce pain or opioid use after orthopedic surgery, though the studies varied widely in design and dosing.

Read the original research

Cannabis and cannabidiol for postoperative pain management in orthopedic surgery: a scoping review.

Pain medicine (Malden, Mass.), 27(2), 111-118

View on PubMed ↗Publisher’s paper ↗

Citation

Tran, Kevin; Odland, Kari; Polly, David W. (2026). Cannabis and cannabidiol for postoperative pain management in orthopedic surgery: a scoping review.. Pain medicine (Malden, Mass.), 27(2), 111-118. https://doi.org/10.1093/pm/pnaf110