Cannabinoids in Orthopaedic Research (with special guest Jason Busse)

Cannabinoids in Orthopaedic Research (with special guest Jason Busse)
OrthoJOE
Cannabinoids in Orthopaedic Research (with special guest Jason Busse)
/
Episode 14 June 21, 2021 00:24:29

Hosted By

Mohit Bhandari, MD Marc Swiontkowski, MD

Show Notes

Orthopaedic patients are increasingly using cannabinoids for pain relief, but there is a lack of evidence-based data on this topic. In this episode, Marc and Mo are joined by special guest Jason Busse (Associate Professor in the Department of Anesthesia at McMaster University, Director of the National Pain Centre, and Associate Director of the Michael G. DeGroote Centre for Medicinal Cannabis Research) in an illuminating discussion on the issues, opportunities, and challenges related to orthopaedic research into the use of cannabinoids. Some of the questions covered during the discussion include:

 

  • What are the most popular claims among cannabis proponents? What evidence is there to support these claims?
  • Is there a causal relationship between cannabinoid use and decreased use of opioids and other prescription medications (i.e., a “substitution effect”)? 
  • Much of the current evidence on cannabinoids is observational and anecdotal. What can we learn from this evidence, and how can such information inform future research? 
  • What are the possible sources of funding for such research?
  • What legal and regulatory hurdles must be overcome in order to allow us to perform properly designed RCTs into this topic?
  • What challenges are faced by physicians when asked by patients about cannabinoids?
  • What research is being done from the patient perspective?
  • What is the roadmap for the future? How we will obtain quality evidence that will help clinicians and their patients to make decisions that are consistent with their values and preferences? 

 

OrthoJOE Mailbag: feedback, comments, and suggestions from our audience can be sent to [email protected]

 

Links:

  • Yun C, Haleem MS, Jeong S, Oyer MA, Driscoll AJ, Chang KY, Yun J, Paul J, Lubbe RJ, Stock SR, Hsu WK, Hsu EL. Effect of Postoperative Analgesic Exposure to the Cannabinoid Receptor Agonist WIN55 on Osteogenic Differentiation and Spinal Fusion in Rats. J Bone Joint Surg Am. 2021 Jun 2;103(11):984-991. doi: 10.2106/JBJS.20.00573. PMID: 33759484. Link.
  • Devinsky O, Patel AD, Cross JH, Villanueva V, Wirrell EC, Privitera M, Greenwood SM, Roberts C, Checketts D, VanLandingham KE, Zuberi SM; GWPCARE3 Study Group. Effect of Cannabidiol on Drop Seizures in the Lennox-Gastaut Syndrome. N Engl J Med. 2018 May 17;378(20):1888-1897. doi: 10.1056/NEJMoa1714631. PMID: 29768152. Link.
  • Devinsky O, Cross JH, Laux L, Marsh E, Miller I, Nabbout R, Scheffer IE, Thiele EA, Wright S; Cannabidiol in Dravet Syndrome Study Group. Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. N Engl J Med. 2017 May 25;376(21):2011-2020. doi: 10.1056/NEJMoa1611618. PMID: 28538134. Link. 
  • Ng JY, Gilotra K, Usman S, Chang Y, Busse JW. Attitudes toward medical cannabis among family physicians practising in Ontario, Canada: a qualitative research study. CMAJ Open. 2021 Apr 13;9(2):E342-E348. doi: 10.9778/cmajo.20200187. PMID: 33849983; PMCID: PMC8084545. Link.
  • NICE Guidelines on cannabis-based medicinal products: https://www.nice.org.uk/guidance/ng144

Other Episodes

Episode cover

March 01, 2021

How is Data Redefining Surgery?

Welcome to the OrthoJOE podcast with Dr. Marc Swiontkowski and Dr. Mohit Bhandari. In this episode of OrthoJOE, Marc and Mo explore both the challenges and opportunities that have risen from the new abundance of online information and what this means for our pursuit of evidence-based medicine in surgery. If you have any comments, questions, or topics you would like us to cover, please feel free to reach out so we can read your messages and possibly answer your questions during the next episode of OrthoJOE. You can contact us through our respective websites (MyOrthoEvidence and JBJS). We intend on having a mailbag portion of the show where we answer questions posed by our listeners. Talking Points: Traditional textbooks and journal articles in digital form look and operate similar to the printed version Application of machine learning to scientific research and clinical practice Future scientific paper: computational notebooks creating opportunity for a "living journal” Point-of-care, data-driven tools of the future Resources/Links: OrthoEvidence, (February 19, 2021- No 42) OrthoEvidence. The Digital Enterprise: Redefining How Data is Changing Surgery. OE Insight. 2021;2(2):3. Available from: https://myorthoevidence.com/Download/9a6a3a4e-405f-4e40-8970-9ffa1f77480b JBJS, Vaid S, Cakan C, Bhandari M. Using Machine Learning to Estimate Unobserved COVID-19 Infections in North America. J Bone Joint Surg Am. 2020 Jul 1;102(13):e70. doi: 10.2106/JBJS.20.00715. PMID: 32618918; PMCID: PMC7396213. https://pubmed.ncbi.nlm.nih.gov/32618918/ Machine Learning Consortium, on behalf of the SPRINT and FLOW Investigators. A Machine Learning Algorithm to Identify Patients with Tibial Shaft Fractures at Risk for Infection After Operative Treatment. J Bone Joint Surg Am. ...

Play

00:17:11

Episode cover

April 26, 2021

Perioperative and Transitional Care

In this episode, Marc and Mo are joined by special guest P.J. Devereaux, Director of the Division of Perioperative Care at McMaster University, in an informative discussion on the future of perioperative and transitional care. With much of the world still dealing with a third wave of the Covid pandemic, and with hospital access continuing to be a challenge because of high rates of ER visits and hospital readmissions, how can we optimize the safety and care of patients both intraoperatively and postoperatively?   How has Covid helped us to rethink how we might improve care for our patients in the future? How can we most effectively monitor patients after they leave the orthopaedic surgical suite?  What measures can we take to send patients home both sooner and safer? What are the roles of technology, personnel, data monitoring, and established protocols in ensuring timely and improved patient care after discharge?  What are the cost considerations associated with technology and technology support? How do these costs compare with those of ER visits and rehospitalizations?  How might the development of a new discipline of perioperative and transitional care help to save lives, provide better patient experiences, improve outcomes, and avoid overloading our ERs and hospitals?    OrthoJOE Mailbag: feedback, comments, and suggestions from our audience can be sent to [email protected]   Links:   Prada C, Chang Y, Poolman R, Johal H, Bhandari M. Best practices for surgeons. COV/0-19 Evidence-Based Scoping Review. https://myoe.blob.core.windows.net/docs/OE-Best-Practices-for-Surgeons-COVID-19-Evidence-Based-Scoping-Review.pdf   ...

Play

00:21:57

Episode cover

January 25, 2021

Cov-19 Crisis and Impact on Orthopaedic Publishing

Welcome to the OrthoJOE podcast with Dr. Marc Swiontkowski and Dr. Mohit Bhandari. In this episode of OrthoJOE, we’ll be talking about the Journal of Bone and Joint Surgery (JBJS) as well as Orthoevidence, our two publications which both have the goals of synthesizing information and making it digestible for the public and professionals in the industry. Today we’re also talking about the impact of COVID-19 on orthopaedic surgery, the speed at which information was disseminated, as well as the publishing standards on this information as it was released to the public.  If you have any comments, questions, or topics you would like us to cover, please feel free to reach out so we can read your messages and possibly answer your questions during the next episode of OrthoJOE. Talking Points: The history and mission statement for Orthoevidence The early days of COVID-19 Infodemic The speed at which information was disseminated  How publishing standards have evolved  Preprint servers and associated use during crisis  Resources/Links: The Journal of Bone and Joint Surgery Orthoevidence JBJS Covid-19 Collection  The "Infodemic" of Journal Publication Associated with the Novel Coronavirus Disease ...

Play

00:21:11