Evidence map›Paper›PMID 39562357›Full record

SynthesisInternational orthopaedics2025

The role of cannabis on total hip and knee surgeries outcomes: a systematic review and meta-analysis.

Amir Human Hoveidaei, Alireza Pouramini, Mohammad-Mehdi Mousavi-Nasab, Pouya Taghavi, Leila Miri, Rachit Saggar, Janet D Conway

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Association of cannabis use disorder with clinical outcomes following lumbar spinal fusion: a propensity-matched cohort study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Amir Human HoveidaeiInternational Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA. hoveidaei.a.h@gmail.com.ORCID 0000-0003-4607-354X
Alireza PouraminiMedical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Mohammad-Mehdi Mousavi-NasabShahid Beheshti University of Medical Sciences, Tehran, Iran.
Pouya TaghaviStudent Research Committee, Kashan University of Medical Sciences, Kashan, Iran.
Leila MiriShahid Beheshti University of Medical Sciences, Tehran, Iran.
Rachit SaggarVMMC and Safdarjung Hospital, New Delhi, India.
Janet D ConwayInternational Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCannabis refers to medications derived from the Cannabis plant. Cannabis has long been used to treat a wide range of conditions. The widespread legalization of cannabis has increased its use. This meta-analysis evaluates the effects of preoperative cannabis usage on TKA and THA outcomes and complications.

methodsThis review follows CRD Guidance for Undertaking Reviews in Healthcare and PRISMA 2020 guidelines. On October 12, 2023, we extensively searched MEDLINE (PubMed), Scopus, Cochrane Central Register of Controlled Trials, and Web of Science. There were no time, place, or language restrictions. We also examined the references and citations in the included publications to find relevant research.

resultsWe found 208 references in PubMed/Medline, Scopus, Web of Science, and other databases. After reviewing all publications, we identified 18 references that match the requirements for further assessment. The odds ratios (ORs) for reoperation and readmission are 1.35 (95% CI: 0.69, 2.66, and p-value = 0.38), and 0.89 (95% CI: 0.41, 1.92, and p-value = 0.76). Inpatient morphine milligram equivalent (MME) and length of stay (LOS) have a mean difference (MD) of -1.71 (95% CI: -13.46, 10.05, and p-value = 0.78), and - 0.13 (95% CI: -0.33, 0.08, and p-value = 0.23). The MD of the VAS pain score 24-72 h after surgery is 0.40 (95% CI: -0.07, 0.87, and p-value = 0.10). The odds ratio for PTE and DVT is 1.54 (95% CI: 0.1, 23.24, and p-value = 0.75), and 1.38 (95% CI: 1.08, 1.77, and p-value = 0.01), respectively.

conclusionCannabis users experienced significantly higher rates of DVT following THA and TKA. Our subgroup analysis found that cannabis users who underwent TKA had considerably higher rates of reoperation (p-value = 0.10) and readmission (p-value ≤ 0.01), while those who underwent THA had significantly lower rates of PTE. These findings highlight the need to include cannabis use as a risk factor in surgical planning and patient care protocols, and further studies are warranted. PROSPERO REGISTRATION: This study design and protocol were performed in accordance with the PRISMA Statement. The protocol was registered previously on PROSPERO CRD42024551078.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeCannabisMedical MarijuanaHumansLength of StayPatient ReadmissionPostoperative ComplicationsReoperationTreatment OutcomeMedical MarijuanaArthroplastyCannabisComplicationsGanjaMarijuana

Identifiers

PMID39562357

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.