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Updated: Jul 4, 2025
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Cannabidiol for Postoperative Pain Control After Arthroscopic Rotator Cuff Repair Demonstrates No Deficits in
Michael J Alaia1, Zachary I Li1, Isabel Chalem1
1Department of Orthopedic Surgery, New York University Langone Health, New York, New York, USA.
Insights
Cannabidiol (CBD) use after rotator cuff repair did not significantly impact long-term pain or patient satisfaction. This study found CBD can be safely included in postoperative pain management without negative effects.
Area of Science:
- Orthopedic surgery
- Pain management
- Pharmacology
Background:
- Cannabidiol (CBD) shows promise for immediate pain relief post-arthroscopic rotator cuff repair (ARCR).
- Long-term effects of perioperative CBD on ARCR outcomes remain unclear.
Purpose of the Study:
- To assess 1-year patient-reported outcomes after ARCR with perioperative CBD versus placebo.
- Evaluate pain, function, and satisfaction in ARCR patients using CBD.
Main Methods:
- A randomized controlled trial (RCT) with 1-year follow-up.
- Patients received either CBD (25-50mg TID) or placebo for 14 days post-ARCR.
- Outcomes included VAS pain, ASES, SANE scores, and patient satisfaction.
Main Results:
- No significant differences in VAS pain, ASES, SANE, or satisfaction at 1-year between CBD and placebo groups.
- High rates of Patient Acceptable Symptom State (PASS) achieved in both groups (81% CBD vs. 77.5% placebo).
Conclusions:
- Perioperative CBD for ARCR did not negatively affect 1-year pain, satisfaction, or functional outcomes.
- CBD can be considered for multimodal pain management post-ARCR without adverse effects.
Background:
Cannabidiol (CBD) has been shown recently to positively affect patient pain and satisfaction immediately after arthroscopic rotator cuff repair (ARCR). However, it is unclear whether the addition of CBD to a perioperative regimen could affect postoperative outcomes.
Purpose:
To evaluate patient-reported outcomes among patients who underwent ARCR and received buccally absorbed CBD or an identical placebo for early postoperative pain management at 1-year follow-up.
Study Design:
Randomized controlled trial; Level of evidence, 2.
Methods:
Eligible patients had previously participated in a multicenter, placebo-controlled, randomized, double-blinded trial that evaluated the analgesic effects of CBD in the immediate postoperative period after ARCR. The experimental group received 25 mg of CBD 3 times/day if <80 kg and 50 mg of CBD 3 times/day if >80 kg for 14 days, with the control group receiving an identical placebo. The following outcomes were assessed at minimum 1-year follow-up: visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE), and patient satisfaction. The rates of achievement of the Patient Acceptable Symptom State (PASS) were compared based on ASES at latest follow-up. Continuous and categorical variables were compared with the Mann-Whitney U test and Fisher exact test, respectively.
Results:
Follow-up was obtained from 83 of 99 patients (83.8%) who completed the original trial. There were no significant differences between the CBD and control groups with respect to age, sex, body mass index, rate of concomitant procedures, or number of anchors used intraoperatively. At 1-year follow-up, there were no significant differences between the CBD and control groups in VAS pain (0.8 vs 1.2, P = .38), ASES (93.0 vs 91.1, P = .71), SANE (87.6 vs 90.1, P = .24), or satisfaction (97.4 vs 95.4, P = .41). A majority of patients achieved the PASS (81.0% [CBD] vs 77.5% [control]; P = .79).
Conclusion:
Perioperative use of CBD for pain control among patients undergoing ARCR did not result in any significant deficits in pain, satisfaction, or patient-reported outcomes at 1-year postoperatively compared with a placebo control group. These findings suggest that CBD can be considered in a postoperative multimodal pain management regimen without detrimental effects on outcome.
Registration:
NCT04672252 (ClinicalTrials.gov identifier).
