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Cannabis y CBD para el dolor

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What the evidence does and doesn't show for cannabis and CBD in musculoskeletal pain, and practical and safety considerations.

Updated Sep 2026
Una hoja de cannabis.
Cada vez se pregunta más sobre el uso del cannabis y el CBD para el dolor musculoesquelético; sin embargo, la evidencia científica y las normativas al respecto siguen evolucionando. Kieran Hirpara 4.0

Esta página se tradujo automáticamente y todavía no la ha revisado un médico. La versión en inglés es la versión oficial.

¿Qué es?

Los medicamentos a base de cannabis incluyen productos elaborados a partir de la planta de cannabis, como el cannabidiol (CBD) y el THC. El CBD es un componente de la planta que no produce efectos psicoactivos; el THC sí lo hace. Estos productos se presentan en forma de aceites, comprimidos o cremas que se pueden ingerir o aplicar sobre la piel.

Las personas que padecen dolor crónico debido a artritis, dolor neuropático o dolor postoperatorio a veces preguntan por estos productos. Muchos pacientes sienten curiosidad. En una encuesta, el 80,9 % de las personas que acuden a una clínica de cirugía de mano y extremidad superior manifestaron que considerarían usar cannabis medicinal [1]. Entre quienes sufren dolor espinal, una de cada tres personas ya lo está utilizando [2]. Un gran número de pacientes con artrosis en la base del pulgar expresaron interés en probarlo [3].

Aún se está investigando cómo actúa el cannabis. El cuerpo humano cuenta con un sistema propio que responde a los componentes activos del cannabis; el CBD y el THC influyen en dicho sistema, el cual, se cree, afecta la percepción del dolor. Algunos médicos consideran que el CBD puede ser útil para controlar el dolor tras cirugías artroscópicas de hombro y el dolor crónico [4]. Estudios preliminares indican que el CBD administrado sublingualmente tras reparación artroscópica del manguito rotador reduce significativamente el dolor en los primeros días postoperatorios [5].

No obstante, los resultados son contradictorios. En el caso del dolor neuropático derivado de lesiones traumáticas del plexo braquial (estiramiento o desgarro de la red nerviosa entre el cuello y el brazo), los ensayos no evidenciaron beneficios clínicamente relevantes al añadir tratamientos a base de cannabis a la terapia farmacológica habitual [6]. Una forma sintética del THC tampoco pareció reducir el consumo de opioides tras cirugía de reemplazo de rodilla [7]. La evidencia actual sí demuestra la eficacia y seguridad del cannabis para el dolor musculoesquelético y neuropático crónico [8]; sin embargo, se requiere más investigación antes de poder ofrecer recomendaciones definitivas para muchas afecciones.

¿Funciona?

La respuesta honesta es que depende de la afección. En el caso del dolor muscular, articular y nervioso crónico, la evidencia actual indica que los cannabinoides pueden ser eficaces y seguros [1]. Asimismo, diversas revisiones sugieren que los medicamentos a base de cannabis podrían ser útiles en la neuropatía periférica, que es el dolor provocado por lesiones en nervios fuera del cerebro y la médula espinal [2]. No obstante, para muchas patologías de la mano y el brazo, la investigación aún no ha avanzado lo suficiente, por lo que no se pueden extraer conclusiones definitivas [1].

Algunos resultados son alentadores. El CBD puede integrarse en un plan terapéutico para el dolor tras una reparación artroscópica del manguito rotador sin afectar el resultado clínico [3], ni generar efectos adversos a largo plazo [4]. En adolescentes y jóvenes sometidos a cirugía artroscópica de cadera, el consumo de marihuana previo a la intervención no modificó sus niveles de dolor, su necesidad de analgésicos ni su recuperación [5]; todos mostraron una notable mejoría postoperatoria, independientemente de si habían consumido o no [5].

Otros hallazgos resultan menos claros. Los adolescentes que informaron haber consumido marihuana antes de una reconstrucción del LCA (ligamento cruzado anterior) presentaron mayor probabilidad de requerir hospitalización nocturna por dolor y tardaron más en volver a practicar deportes [6]. Asimismo, un estudio sobre el uso simultáneo de cannabis y nicotina tras cirugía por fractura de miembro superior no detectó riesgos adicionales evidentes; sin embargo, quizá el tamaño de la muestra fue insuficiente para identificarlos [7].

En resumen, la evidencia es realmente heterogénea. Algunos datos respaldan el uso de medicamentos a base de cannabis en casos de dolor crónico; otros indican que no surten efecto; y otros plantean dudas en pacientes jóvenes. Si está pensando en utilizar estos productos, hable con su médico, quien podrá evaluar la evidencia en relación con su condición específica.

¿Cuáles son los riesgos?

La respuesta honesta es que la investigación sobre su seguridad todavía es fragmentaria, y depende del producto que se utilice y del motivo por el cual se emplea. A continuación se detalla lo que la evidencia sí y no demuestra.

En cuanto al CBD administrado sublingualmente tras una reparación artroscópica de tendones del hombro, los estudios arrojaron un perfil de seguridad aceptable [1]. Se podría emplear como parte de un plan de control del dolor sin afectar el resultado quirúrgico [2], ni causar daños a largo plazo [3]. Este es el indicador de seguridad más claro que tenemos; sin embargo, proviene de un único tipo de cirugía y de una sola forma de administración.

En cuanto a los medicamentos a base de cannabis en general, la evidencia actual indica que pueden ser eficaces y seguros para el tratamiento a largo plazo del dolor muscular, articular y nervioso [4]. No obstante, esta conclusión viene acompañada de una advertencia: para muchas patologías de la mano y el brazo se requiere más investigación para llegar a conclusiones definitivas [4]. Asimismo, algunas revisiones sugieren que podrían ser útiles en la neuropatía periférica, es decir, el dolor derivado de lesiones en nervios fuera del cerebro y la médula espinal [5].

Algunos hallazgos, en cambio, generan más dudas que tranquilidad. Los adolescentes que consumieron marihuana antes de una reconstrucción del ligamento cruzado anterior de la rodilla tuvieron mayor probabilidad de requerir hospitalización nocturna por dolor y tardaron más en volver a practicar deportes [6]. En cuanto al uso conjunto de cannabis y nicotina tras una cirugía por fractura de miembro superior, un estudio no detectó riesgos adicionales evidentes; sin embargo, quizás el estudio fue demasiado pequeño para identificarlos [7]. Por último, en el caso del dolor nervioso provocado por lesiones traumáticas del plexo braquial (estiramiento o desgarro de la red nerviosa entre el cuello y el brazo), los ensayos no mostraron beneficios clínicamente relevantes al añadir tratamientos a base de cannabis a la terapia farmacológica habitual [8].

En el caso de adolescentes y jóvenes sometidos a cirugía artroscópica de cadera, el consumo de marihuana antes de la intervención no influyó en los niveles de dolor, en la necesidad de analgésicos ni en la recuperación [9].

En resumen, la situación es heterogénea. Si está considerando el uso de estos productos, hable al respecto con su médico, quien podrá evaluar la evidencia en relación con su condición específica.

¿Es adecuado para usted?

No existe ninguna prueba sencilla para determinarlo. La evidencia indica que existen ciertos grupos de pacientes para quienes estos productos podrían ser útiles, y otros para quienes probablemente no lo sean.

Si padece dolor muscular, articular o nervioso crónico, la evidencia actual demuestra que los medicamentos a base de cannabis son eficaces y seguros [1]. Asimismo, diversos estudios señalan que podrían ser útiles para el dolor provocado por problemas en los nervios fuera del cerebro y la médula espinal [2]. En pacientes sometidos a reparación artroscópica de tendones del hombro, el CBD administrado por vía sublingual ha mostrado resultados prometedores en los primeros días postoperatorios al reducir el dolor [3], con un perfil de seguridad aceptable [3].

Sin embargo, hay situaciones en las que su uso no se recomienda. En casos de dolor nervioso derivado de una lesión traumática del plexo braquial (estiramiento o desgarro de la red nerviosa entre el cuello y el brazo), los ensayos no hallaron beneficios clínicamente relevantes al añadir tratamientos a base de cannabis a la terapia farmacológica habitual [4]. En pacientes sometidos a cirugía de reemplazo de rodilla, una forma sintética de THC no logró reducir el consumo de opioides (analgésicos potentes) [5]. Por último, en adolescentes sometidos a reconstrucción del LCA (ligamento de la rodilla), el consumo previo de marihuana se asoció con una estancia hospitalaria más prolongada y una recuperación deportiva más lenta [6].

En comparación con los analgésicos convencionales, estos productos no constituyen un sustituto. Lo más adecuado es considerarlos una opción adicional que su médico podría incorporar a un plan terapéutico que ya incluya otros tratamientos.

Esta decisión debe tomarse conjuntamente con su médico. Él conoce su condición, los demás medicamentos que toma y su historial clínico, por lo que podrá evaluar la evidencia de forma personalizada para usted.

Conclusión

Los medicamentos a base de cannabis podrían formar parte de su plan de tratamiento para el dolor, pero eso depende de su afección. En el caso del dolor muscular, articular y nervioso crónico, la evidencia indica que son eficaces y seguros [1]. Asimismo, diversas revisiones sugieren que podrían ser útiles para el dolor provocado por problemas en nervios fuera del cerebro y la médula espinal [2]. No obstante, en el caso de muchas afecciones de la mano y el brazo, la investigación aún no ha avanzado lo suficiente [1]. Por ello, es importante tener expectativas realistas: estos productos constituyen una opción a considerar, pero no una solución comprobada para todos los casos. La advertencia más importante es que la evidencia científica es contradictoria; por eso, consulte a su médico antes de probar cualquier tratamiento.

Referencias

[1] Perspectivas de los pacientes de cirugía de mano respecto al cannabis medicinal: una encuesta con más de 600 pacientes. Journal of Hand Surgery Global Online. 2023. DOI: 10.1016/j.jhsg.2022.02.009

[2] Percepciones en la cirugía ortopédica sobre el uso del cannabis para tratar el dolor: una encuesta con pacientes con dolor espinal (POSIT Spine). Journal of Orthopaedic Surgery and Research. 2024. DOI: 10.1186/s13018-024-04558-6

[3] Evaluación del cannabis medicinal en pacientes con artrosis de la articulación trapecio-metacarpiana. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2021.10.018

[4] Póster 373: Percepciones y opiniones sobre el cannabidiol entre cirujanos ortopédicos especializados en medicina deportiva. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/2325967123s00336

[5] Efectos del cannabidiol en el dolor postoperatorio tras la reparación artroscópica del manguito rotador. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2023.02.032

[6] CORR Insights®: ¿Mejora el uso de medicamentos a base de cannabis el dolor y la calidad del sueño en pacientes con lesiones traumáticas del plexo braquial? Un ensayo controlado aleatorizado, cruzado y triple ciego. Clinical Orthopaedics & Related Research. 2024. DOI: 10.1097/corr.0000000000003265

[7] Una forma sintética de cannabinoide no reduce el consumo de opioides tras la artroplastia total de rodilla: un estudio prospectivo, aleatorizado, triple ciego y controlado con placebo. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.02.047

[8] El cannabis medicinal en la cirugía de mano: revisión de la evidencia actual. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2022.11.008

[9] Uso de cannabinoides en el tratamiento de la neuropatía periférica y el dolor neuropático: una revisión sistemática. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.09.015

[10] El cannabidiol para el control del dolor postoperatorio tras la reparación artroscópica del manguito rotador no presenta deficiencias en los resultados reportados por los pacientes en comparación con el placebo: seguimiento a 1 año de un ensayo controlado aleatorizado. Orthopaedic Journal of Sports Medicine. 2024. DOI: 10.1177/23259671231222265

[11] Póster 186: El cannabidiol para el control del dolor postoperatorio tras la reparación artroscópica del manguito rotador no genera deficiencias funcionales a los 1 año. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/2325967123s00172

[12] No existen evidencias de que el consumo previo de marihuana influya en el éxito de la artroscopia de cadera para el tratamiento del conflicto femoroacetabular en adolescentes y adultos jóvenes. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/23259671251385152

[13] Efecto del consumo de marihuana en el manejo del dolor y el retorno a la actividad deportiva tras la reconstrucción del ligamento cruzado anterior en pacientes pediátricos y adolescentes: un estudio con grupos control emparejados. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/23259671251369015

[14] El consumo de cannabis y nicotina se asocia de forma independiente con resultados quirúrgicos, médicos y psicosociales adversos tras la fijación de fracturas de extremidades superiores. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-025-06635-w

Reviewed by Kieran Hirpara · 13 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without detrimental effects on patient-reported outcomes at 1-year follow-up after arthroscopic rotator cuff repair [1].
  • CBD can be considered in a postoperative multimodal pain management regimen without long-term functional deficits at 1-year follow-up after arthroscopic rotator cuff repair [2].
  • Cannabis-based medicines are applicable for the treatment of peripheral neuropathy and neuropathic pain [3].
  • 89% of participants in a survey of musculoskeletal pain patients considered medical cannabis to be more effective than narcotics for adequate pain management [4].
  • Regular cannabis use may be associated with increased opioid usage in the context of total joint arthroplasty [5].
  • No specific guidance for the use of cannabis in perioperative pain management can be suggested based on the association between regular cannabis use and increased opioid usage after total joint arthroplasty [5].
  • Patients estimated that medical cannabis could treat more than half of their spine pain [6].
  • One in three patients with spine pain were already using medical cannabis [6].
  • 79% of patients with spine pain believe cannabis could reduce opioid usage [6].
  • Most survey respondents in the orthopaedic sports medicine community believed that CBD has a role in postoperative and chronic pain management [7].
  • Large numbers of patients with osteoarthritis of the thumb basal joint would be interested in trialing either oral or topical formulations of medical cannabis for treatment of their pain [8].
  • 80.9% of patients presenting for hand and upper-extremity complaints would consider using medical cannabis [9].
  • Patients presenting for hand and upper-extremity complaints perceive medical cannabis as a safe treatment option for common orthopedic conditions [9].
  • Cost is identified as a major barrier to the use of medical cannabis by patients presenting for hand and upper-extremity complaints [9].
  • A synthetic form of THC does not appear to limit opioid intake after primary total knee arthroplasty [10].
  • Current evidence demonstrates efficacy and safety for chronic musculoskeletal and neuropathic pain [19].
  • Definitive conclusions regarding the efficacy of medical cannabis in hand and upper extremity conditions require continued investigation [19].

How It Works

  • Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without long-term functional deficits at 1-year follow-up after arthroscopic rotator cuff repair [2].
  • 89% of participants considered medical cannabis to be more effective than narcotics for adequate pain management [4].
  • No specific guidance in the use of cannabis in perioperative pain management can be suggested based on the association between regular cannabis use and increased opioid usage after total joint arthroplasty [5].
  • Cannabis-based medicine did not provide clinical improvement in pain compared with a placebo in patients with traumatic brachial plexus injuries [11].
  • A majority of sports medicine surgeons believe that CBD has a role in post-operative and chronic pain management [12].
  • More clinical research for cannabinoids is needed to help orthopaedic traumatologists provide guidance for patients seeking advice for this therapeutic [13].
  • Patients with documented cannabis dependence demonstrated higher odds of developing wound complications following hand and wrist soft-tissue surgical procedures [16].

What the Evidence Shows

Postoperative Pain Management

  • CBD can be considered in a post-operative multimodal pain management regimen without long-term functional deficits at 1-year follow-up after arthroscopic rotator cuff repair [2].
  • Buccally absorbed CBD demonstrates an acceptable safety profile and shows significant promise in reducing pain in the immediate peri-operative period following arthroscopic rotator cuff repair compared to control [17].
  • Cannabis use does not affect outcomes after total hip arthroplasty [14].
  • Further studies are warranted to determine the efficacy and safety of perioperative cannabis use after total hip arthroplasty to help guide orthopaedic surgeons in counseling patients [14].
  • Higher-level studies are needed to ascertain the impact of cannabis use for patients undergoing total joint arthroplasty [15].

Neuropathic Pain

  • Cannabis-based treatment did not provide clinically important benefit as an adjuvant to standard multimodal drug therapy for neuropathic pain in traumatic brachial plexus injuries [18].
  • Findings suggest the applicability of cannabis-based medicines for peripheral neuropathy [3].

Patient and Surgeon Perceptions

  • Patients estimated medical cannabis could treat more than half of their spine pain [6].

Practical Considerations

Postoperative Pain Management

  • CBD can be considered in a postoperative multimodal pain management regimen without detrimental effects on outcome [1].
  • CBD can be considered in a post-operative multimodal pain management regimen without long-term detrimental effects [2].

Patient and Provider Perceptions

  • Large numbers of patients with osteoarthritis of the thumb basal joint would be interested in trialing either oral or topical formulations of medical cannabis for treatment of their thumb basal joint pain [8].

Clinical Guidance and Research Needs

  • No specific guidance in the use of cannabis in perioperative pain management can be suggested based on the association between regular cannabis use and increased opioid usage in total joint arthroplasty [5].
  • More clinical research for cannabinoids is needed to help orthopaedic traumatologists provide guidance for patients seeking advice [13].

Key Evidence

  • [L2] These findings suggest that CBD can be considered in a postoperative multimodal pain management regimen without detrimental effects on outcome. [1] (10.1177/23259671231222265)
  • [L2] These findings suggest that CBD can be considered in a post-operative multimodal pain management regimen without long-term detrimental effects. [2] (10.1177/2325967123s00172)
  • [L2] These findings suggest the applicability of cannabis-based medicines for peripheral neuropathy. [3] (10.1016/j.jhsa.2024.09.015)
  • [L4] In addition, 89% of the participants considered medical cannabis to be more effective than narcotics for adequate pain management. [4] (10.5435/jaaosglobal-d-22-00055)
  • [Paper] Regular cannabis use may be associated with increased opioid usage in the context of total joint arthroplasty, and no specific guidance in the use of cannabis in perioperative pain management can be suggested based on this discovery. [5] (10.1097/corr.0000000000003472)
  • [L4] Patients estimated medical cannabis could treat more than half of their spine pain, with one in three patients already using medical cannabis, and 79% of patients believe cannabis could reduce opioid usage. [6] (10.1186/s13018-024-04558-6)
  • [L4] Most survey respondents believed that CBD has a role in postoperative and chronic pain management. [7] (10.1177/23259671231191766)
  • [L4] Large numbers of these patients would be interested in trialing either oral or topical formulations of medical cannabis for treatment of their thumb basal joint pain. [8] (10.1016/j.jhsa.2021.10.018)
  • [L3] Most patients presenting for hand and upper-extremity complaints would consider using medical cannabis (80.9%) and perceive it as a safe treatment option for common orthopedic conditions, with cost identified as a major barrier to use. [9] (10.1016/j.jhsg.2022.02.009)
  • [L1] Despite enthusiasm for cannabis after orthopaedic surgical procedures, this THC does not appear to limit opioid intake after primary TKA. [10] (10.1016/j.arth.2026.02.047)
  • [L1] Cannabis-based medicine did not provide clinical improvement in pain compared with a placebo in patients with traumatic brachial plexus injuries. [11] (10.1097/corr.0000000000003221)
  • [L4] A majority of sports medicine surgeons believe that CBD has a role in post-operative and chronic pain management. [12] (10.1177/2325967123s00336)
  • [L4] More clinical research for cannabinoids is needed to help orthopaedic traumatologists provide guidance for patients seeking advice for this recently popular therapeutic. [13] (10.5435/jaaosglobal-d-21-00047)
  • [L3] Further studies are warranted to determine the efficacy and safety of perioperative cannabis use after THA to help guide orthopaedic surgeons in counseling patients. [14] (10.1016/j.arth.2023.03.040)
  • [L1] Higher-level studies are needed to ascertain the impact of cannabis use for patients undergoing TJA. [15] (10.1016/j.arth.2023.07.008)
  • [L2] Patients with documented cannabis dependence demonstrated higher odds of developing wound complications following hand and wrist soft-tissue surgical procedures. [16] (10.1016/j.jhsg.2026.100948)
  • [L1] Buccally absorbed CBD demonstrates an acceptable safety profile and shows significant promise in reduction of pain in the immediate peri-operative period following ARCR compared to the control. [17] (10.1016/j.jse.2023.02.032)
  • [Paper] This is a commentary on a randomized controlled trial by Kittithamvongs et al., which found no clinically important benefit to cannabis-based treatment as an adjuvant to standard multimodal drug therapy for neuropathic pain in traumatic brachial plexus injuries. [18] (10.1097/corr.0000000000003265)
  • [L4] Current evidence demonstrates efficacy and safety for chronic musculoskeletal and neuropathic pain, but definitive conclusions regarding efficacy in hand and upper extremity conditions require continued investigation. [19] (10.1016/j.jhsa.2022.11.008)

References

[1] Cannabidiol for Postoperative Pain Control After Arthroscopic Rotator Cuff Repair Demonstrates No Deficits in Patient-Reported Outcomes Versus Placebo: 1-Year Follow-up of a Randomized Controlled Trial. Orthopaedic Journal of Sports Medicine. 2024. DOI: 10.1177/23259671231222265

[2] Poster 186: Cannabidiol for Post-Operative Pain Control after Arthroscopic Rotator Cuff Repair Demonstrates No Functional Deficits at 1-Year. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/2325967123s00172

[3] The Use of Cannabinoids in the Treatment of Peripheral Neuropathy and Neuropathic Pain: A Systematic Review. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.09.015

[4] Patient Experience and Perspective on Medical Cannabis as an Alternative for Musculoskeletal Pain Management. JAAOS: Global Research and Reviews. 2022. DOI: 10.5435/jaaosglobal-d-22-00055

[5] CORR Insights®: Do Medical and Recreational Marijuana State Laws Impact Trends in Postoperative Opioid Prescriptions Among Patients Who Have Undergone TJA?. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003472

[6] Perceptions in orthopedic surgery on the use of cannabis in treating pain: a survey of patients with spine pain (POSIT Spine). Journal of Orthopaedic Surgery and Research. 2024. DOI: 10.1186/s13018-024-04558-6

[7] Perceptions and Opinions on Cannabidiol in the Orthopaedic Sports Medicine Community. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/23259671231191766

[8] Assessment of Medical Cannabis in Patients With Osteoarthritis of the Thumb Basal Joint. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2021.10.018

[9] Hand Surgery Patient Perspectives on Medical Cannabis: A Survey of Over 600 Patients. Journal of Hand Surgery Global Online. 2023. DOI: 10.1016/j.jhsg.2022.02.009

[10] A Synthetic Form of Cannabinoid Does Not Decrease Opioid Use After Total Knee Arthroplasty: A Prospective, Randomized, Triple-Blind, Placebo-Controlled Study. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.02.047

[11] Does Cannabis-based Medicine Improve Pain and Sleep Quality in Patients With Traumatic Brachial Plexus Injuries? A Triple-blind, Crossover, Randomized Controlled Trial. Clinical Orthopaedics & Related Research. 2024. DOI: 10.1097/corr.0000000000003221

[12] Poster 373: Perceptions & Opinions on Cannabidiol Among Sports Medicine Orthopaedic Surgeons. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/2325967123s00336

[13] Knowledge and Opinion on Cannabinoids Among Orthopaedic Traumatologists. JAAOS: Global Research and Reviews. 2021. DOI: 10.5435/jaaosglobal-d-21-00047

[14] Cannabis Use Does Not Affect Outcomes After Total Hip Arthroplasty. The Journal of Arthroplasty. 2023. DOI: 10.1016/j.arth.2023.03.040

[15] Cannabis Use Following Total Joint Arthroplasty is Associated With Increased Risks? A Meta-Analysis. The Journal of Arthroplasty. 2024. DOI: 10.1016/j.arth.2023.07.008

[16] Is Cannabis Dependence Associated with Postoperative Infections in Hand and Wrist Surgeries?. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.100948

[17] Effects Of Cannabidiol On Post-Operative Pain Following Arthroscopic Rotator Cuff Repair. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2023.02.032

[18] CORR Insights®: Does Cannabis-based Medicine Improve Pain and Sleep Quality in Patients With Traumatic Brachial Plexus Injuries? A Triple-blind, Crossover, Randomized Controlled Trial. Clinical Orthopaedics & Related Research. 2024. DOI: 10.1097/corr.0000000000003265

[19] Medical Cannabis in Hand Surgery: A Review of the Current Evidence. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2022.11.008

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Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.