Functional Outcomes After Hip Arthroscopy Based on Self-Reported Cannabis Use: A Matched-Controlled Study

There is a paucity of literature investigating the impact of cannabis usage on functional outcomes after primary hip arthroscopy surgery to treat symptomatic labral tears.

To compare patient-reported outcome measures (PROM) for hip arthroscopy patients who did and did not self-report cannabis use, understand how frequency of cannabis use correlates to PROMs, and compare rates of achieving clinically meaningful outcomes for both cohorts.

Cohort study; Level of evidence, 3.

This was a matched-control cohort study of patients who underwent primary hip arthroscopy for symptomatic labral tears. Included patients were ≥18 years old and completed baseline and 2-year postoperative outcomes surveys. Excluded patients had missing follow-up data, previous ipsilateral hip surgery or revision surgery, and/or hip dysplasia (lateral center-edge angle ≤20°). Patients were retrospectively divided into 2 groups based on whether they were cannabis naive (CN) or cannabis users by reviewing their social history. The 2 groups were then propensity-matched 1:1 by age, sex, body mass index, and Tönnis grade. PROMs were collected prospectively at baseline and 2 years postoperatively. These included the modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sports Specific Subscale, 33-item International Hip Outcome Tool, Lower Extremity Functional Score, and RAND-36 pain subscale (Pain).

In total, 68 patients were included (aged 31.4 ± 9.67 years). Of these, 34 patients had self-reported cannabis use, and 34 did not report use. All PROM scales were similar at baseline (P > .05). Cannabis use was not a predictor of functional outcomes at any time point, including the 2-year follow-up for all PROM scales (P > .05); however, the improvement in Pain scores was significantly better in the CN cohort from baseline to the 2-year follow-up (27.3 ± 28.8 vs 11.6 ± 19.0, P = .012). A linear regression model adjusting for cannabis use frequency found pain scores worsened with increased usage (adjusted mean difference, -2.68; 95% CI, -5.12 to -0.25; P = .031). Further analysis showed no differences in achieving minimal clinically important difference, patient acceptable symptom state, or substantial clinical benefit (P > .05).

Self-reported cannabis usage has no impact on raw functional outcomes after hip arthroscopy, but increased usage correlates with worse pain symptoms.