Marijuana use is Associated with Increased Rates of Hip Dislocation and Lower Insurance Reimbursement among THA Recipients

This study utilizes an all-payer database to compare 90-d and 1-year outcomes between marijuana and non-marijuana users undergoing total hip arthroplasty (THA). The primary aim of this study focused on 90-d and 1-year opioid consumption among marijuana users and non-users who underwent THA. Our secondary aim focused on comparing 90-d and 1-year rates of readmissions, revisions and adverse events between the two groups. A retrospective review was performed in the Mariner Database for all primary THA patients from 2010 to 2018. Marijuana users were identified utilizing International Classification of Diseases (ICD) 9 and 10 codes and matched 1:1 to non-marijuana users on age, sex, Charlson Comorbidity Index (CCI), obesity, alcohol, tobacco, illicit drug use, history of drug abuse, and presence of psychiatric history. This yielded a total of 1654 patients in each group. The 90-d and 1-year outcomes included opioid consumption, episode of care costs, readmissions, revisions, and complications. Chi-square was employed to assess categorical variables, while t-tests were employed for continuous variables. There was no difference in opioid consumption among marijuana users and non-marijuana users who underwent a THA. Marijuana use was associated with lower 90-d costs of care when compared with non-marijuana users. Marijuana users had higher rates of hip dislocation within 90 d and 1 year of surgery. Marijuana use is associated with higher 90-d and 1-year dislocation rates. THA recipients who use marijuana should be counseled concerning this increased risk. Prospective randomized control trials are needed to verify the results of this study.