Dhruv S Shankar, Brittany DeClouette, Kinjal D Vasavada, Amanda Avila, Eric J Strauss, Michael J Alaia, Guillem Gonzalez-Lomas
{"title":"前交叉韧带重建术后，大麻使用障碍与阿片类镇痛药的使用或患者自述结果无关：一项回顾性匹配队列分析。","authors":"Dhruv S Shankar, Brittany DeClouette, Kinjal D Vasavada, Amanda Avila, Eric J Strauss, Michael J Alaia, Guillem Gonzalez-Lomas","doi":"10.1177/19417381231190391","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to compare opioid analgesic use and patient-reported outcomes (PROs) after anterior cruciate ligament reconstruction (ACLR) between patients with and without cannabis use disorder (CUD).</p><p><strong>Hypothesis: </strong>We hypothesized that patients with CUD would have greater postoperative opioid usage with comparable improvement in PROs.</p><p><strong>Study design: </strong>Retrospective matched-cohort study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>We identified patients with CUD who underwent primary ACLR at a single center and had minimum 3-month follow-up. Patients with CUD were propensity score matched 1:1 to non-CUD controls with respect to age, sex, and follow-up time. Total refills, days supply, and morphine milligram equivalents (MMEs) of opioid analgesics prescribed were calculated for up to 1 year postoperatively. Patient-Reported Outcome Information System (PROMIS) instruments were used to assess PROs. Opioid use and outcomes were compared between CUD and control groups using Mann-Whitney <i>U</i> test and Fisher's exact test. <i>P</i> values <0.05 were considered significant.</p><p><strong>Results: </strong>A total of 104 patients with CUD were matched to 104 controls. Both groups were majority male (65.4% male, 34.6% female). The CUD group had a mean age of 29.9 years and mean follow-up time of 16.1 months. There was no significant intergroup difference in opioid prescription rates (CUD 82.7% vs control 83.7%, <i>P</i> ≥ 0.99). Among patients prescribed opioids, there were no significant intergroup differences in total days supply (<i>P</i> = 0.67), total MMEs (<i>P</i> = 0.71), or MMEs per day (<i>P</i> = 0.65). There were no significant differences in pre- to postoperative improvement in PROMIS Pain Intensity (<i>P</i> = 0.51), Pain Interference (<i>P</i> = 0.81), Mobility (<i>P</i> = 0.90), Mental Health (<i>P</i> = 0.74), or Physical Health (<i>P</i> = 0.94).</p><p><strong>Conclusion: </strong>There were no significant differences detected in opioid usage or PRO improvement after ACLR between patients with CUD and those without. However, because a sample size was not determined a priori, a larger sample may show a difference.</p><p><strong>Clinical relevance: </strong>CUD does not appear to correlate with inferior outcomes after ACLR.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346227/pdf/","citationCount":"0","resultStr":"{\"title\":\"Cannabis Use Disorder Not Associated With Opioid Analgesic Use or Patient-Reported Outcomes After ACL Reconstruction: A Retrospective Matched-Cohort Analysis.\",\"authors\":\"Dhruv S Shankar, Brittany DeClouette, Kinjal D Vasavada, Amanda Avila, Eric J Strauss, Michael J Alaia, Guillem Gonzalez-Lomas\",\"doi\":\"10.1177/19417381231190391\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The purpose of this study was to compare opioid analgesic use and patient-reported outcomes (PROs) after anterior cruciate ligament reconstruction (ACLR) between patients with and without cannabis use disorder (CUD).</p><p><strong>Hypothesis: </strong>We hypothesized that patients with CUD would have greater postoperative opioid usage with comparable improvement in PROs.</p><p><strong>Study design: </strong>Retrospective matched-cohort study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>We identified patients with CUD who underwent primary ACLR at a single center and had minimum 3-month follow-up. Patients with CUD were propensity score matched 1:1 to non-CUD controls with respect to age, sex, and follow-up time. Total refills, days supply, and morphine milligram equivalents (MMEs) of opioid analgesics prescribed were calculated for up to 1 year postoperatively. Patient-Reported Outcome Information System (PROMIS) instruments were used to assess PROs. Opioid use and outcomes were compared between CUD and control groups using Mann-Whitney <i>U</i> test and Fisher's exact test. <i>P</i> values <0.05 were considered significant.</p><p><strong>Results: </strong>A total of 104 patients with CUD were matched to 104 controls. Both groups were majority male (65.4% male, 34.6% female). The CUD group had a mean age of 29.9 years and mean follow-up time of 16.1 months. There was no significant intergroup difference in opioid prescription rates (CUD 82.7% vs control 83.7%, <i>P</i> ≥ 0.99). Among patients prescribed opioids, there were no significant intergroup differences in total days supply (<i>P</i> = 0.67), total MMEs (<i>P</i> = 0.71), or MMEs per day (<i>P</i> = 0.65). There were no significant differences in pre- to postoperative improvement in PROMIS Pain Intensity (<i>P</i> = 0.51), Pain Interference (<i>P</i> = 0.81), Mobility (<i>P</i> = 0.90), Mental Health (<i>P</i> = 0.74), or Physical Health (<i>P</i> = 0.94).</p><p><strong>Conclusion: </strong>There were no significant differences detected in opioid usage or PRO improvement after ACLR between patients with CUD and those without. However, because a sample size was not determined a priori, a larger sample may show a difference.</p><p><strong>Clinical relevance: </strong>CUD does not appear to correlate with inferior outcomes after ACLR.</p>\",\"PeriodicalId\":54276,\"journal\":{\"name\":\"Sports Health-A Multidisciplinary Approach\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346227/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sports Health-A Multidisciplinary Approach\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/19417381231190391\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/8/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"SPORT SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sports Health-A Multidisciplinary Approach","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/19417381231190391","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/26 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SPORT SCIENCES","Score":null,"Total":0}
Cannabis Use Disorder Not Associated With Opioid Analgesic Use or Patient-Reported Outcomes After ACL Reconstruction: A Retrospective Matched-Cohort Analysis.
Background: The purpose of this study was to compare opioid analgesic use and patient-reported outcomes (PROs) after anterior cruciate ligament reconstruction (ACLR) between patients with and without cannabis use disorder (CUD).
Hypothesis: We hypothesized that patients with CUD would have greater postoperative opioid usage with comparable improvement in PROs.
Study design: Retrospective matched-cohort study.
Level of evidence: Level 3.
Methods: We identified patients with CUD who underwent primary ACLR at a single center and had minimum 3-month follow-up. Patients with CUD were propensity score matched 1:1 to non-CUD controls with respect to age, sex, and follow-up time. Total refills, days supply, and morphine milligram equivalents (MMEs) of opioid analgesics prescribed were calculated for up to 1 year postoperatively. Patient-Reported Outcome Information System (PROMIS) instruments were used to assess PROs. Opioid use and outcomes were compared between CUD and control groups using Mann-Whitney U test and Fisher's exact test. P values <0.05 were considered significant.
Results: A total of 104 patients with CUD were matched to 104 controls. Both groups were majority male (65.4% male, 34.6% female). The CUD group had a mean age of 29.9 years and mean follow-up time of 16.1 months. There was no significant intergroup difference in opioid prescription rates (CUD 82.7% vs control 83.7%, P ≥ 0.99). Among patients prescribed opioids, there were no significant intergroup differences in total days supply (P = 0.67), total MMEs (P = 0.71), or MMEs per day (P = 0.65). There were no significant differences in pre- to postoperative improvement in PROMIS Pain Intensity (P = 0.51), Pain Interference (P = 0.81), Mobility (P = 0.90), Mental Health (P = 0.74), or Physical Health (P = 0.94).
Conclusion: There were no significant differences detected in opioid usage or PRO improvement after ACLR between patients with CUD and those without. However, because a sample size was not determined a priori, a larger sample may show a difference.
Clinical relevance: CUD does not appear to correlate with inferior outcomes after ACLR.
期刊介绍：
Sports Health: A Multidisciplinary Approach is an indispensable resource for all medical professionals involved in the training and care of the competitive or recreational athlete, including primary care physicians, orthopaedic surgeons, physical therapists, athletic trainers and other medical and health care professionals.
Published bimonthly, Sports Health is a collaborative publication from the American Orthopaedic Society for Sports Medicine (AOSSM), the American Medical Society for Sports Medicine (AMSSM), the National Athletic Trainers’ Association (NATA), and the Sports Physical Therapy Section (SPTS).
The journal publishes review articles, original research articles, case studies, images, short updates, legal briefs, editorials, and letters to the editor.
Topics include:
-Sports Injury and Treatment
-Care of the Athlete
-Athlete Rehabilitation
-Medical Issues in the Athlete
-Surgical Techniques in Sports Medicine
-Case Studies in Sports Medicine
-Images in Sports Medicine
-Legal Issues
-Pediatric Athletes
-General Sports Trauma
-Sports Psychology
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