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Cannabis e CBD para dor

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

Updated Sep 2026
Uma folha de cannabis.
Cada vez mais pessoas perguntam sobre cannabis e CBD para dores musculoesqueléticas; as evidências e as regras ainda estão evoluindo. Kieran Hirpara 4.0

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

O que é

Os medicamentos à base de cannabis incluem produtos feitos a partir da planta cannabis, entre eles o canabidiol (CBD) e o THC. O CBD é uma parte da planta que não causa o efeito de "barato". O THC é a parte que causa. Esses produtos vêm na forma de óleos, comprimidos ou cremes para passar na pele.

Pessoas com dor de longa duração por artrose, dor nos nervos ou dor após uma cirurgia às vezes perguntam sobre eles. Muitos pacientes têm curiosidade. Em uma pesquisa, 80,9% das pessoas atendidas em um ambulatório de mão e membro superior disseram que considerariam usar cannabis medicinal [1]. Entre as pessoas com dor na coluna, uma em cada três já a usava [2]. Um grande número de pessoas com artrose por desgaste na base do polegar disse que teria interesse em experimentar [3].

A forma como ela age ainda está sendo estudada. O seu corpo tem um sistema próprio que responde a substâncias presentes na cannabis, e esse sistema participa da forma como você sente dor. Uma revisão relatou que as evidências atuais sugerem benefício e segurança para a dor de longa duração nos músculos, ossos e nervos [4]. Mas o quadro é misto. Ensaios clínicos não encontraram benefício clinicamente importante para a dor nos nervos após lesões do plexo braquial (uma lesão por estiramento dos nervos que vão do pescoço até o braço) [5]. Uma forma sintética de THC não pareceu reduzir o consumo de opioides após a cirurgia de prótese de joelho [6].

Há alguns cuidados. O uso regular de cannabis foi associado a um maior consumo de opioides após a cirurgia de prótese articular [7]. Pessoas com dependência de cannabis documentada tiveram maior probabilidade de problemas na ferida após cirurgias de partes moles da mão e do punho [8]. São necessárias mais pesquisas antes que se possa dar uma orientação clara para muitas condições [9, 4].

Funciona mesmo?

A resposta honesta é que depende de para que você está usando. Para dores de longa duração nos músculos, ossos e nervos, uma revisão relatou que as evidências atuais sugerem benefício e segurança dos medicamentos à base de cannabis [4]. Uma revisão também constatou que eles podem ajudar na dor nos nervos dos membros, fora da coluna [11]. Mas, especificamente para condições da mão e do braço, os pesquisadores dizem que ainda precisamos de mais estudos antes de tirar conclusões firmes [4].

Há alguns resultados animadores em relação à cirurgia. O CBD pode ser incluído em um plano combinado de alívio da dor após o reparo do manguito rotador por vídeo sem prejudicar a sua recuperação a curto ou longo prazo [12, 13]. Isso significa que ele não piorou os resultados, e não que tenha sido comprovado que ele os melhora. Entre adolescentes e adultos jovens submetidos a cirurgia do quadril por vídeo, os que usavam maconha antes da cirurgia tiveram os mesmos níveis de dor, a mesma necessidade de analgésicos e a mesma recuperação que os que não usavam [14].

Alguns resultados são menos positivos. Entre adolescentes submetidos a reconstrução de ligamento do joelho, os que relataram uso de maconha precisaram de internação durante a noite por causa da dor com mais frequência e demoraram mais para voltar ao esporte [15]. Assim, a mesma substância pode parecer inofensiva em uma situação e problemática em outra.

Vale a pena saber quem costuma usá-la. As pessoas submetidas a cirurgia por vídeo que relatam uso de cannabis costumam ser mais jovens e, com mais frequência, do sexo masculino [16]. E a maioria das pessoas atendidas em um ambulatório de mão e membro superior vê a cannabis medicinal como uma opção segura para problemas ortopédicos comuns [1].

Em resumo: há evidências reais para alguns usos, evidências mistas para outros e ainda nenhum bom ensaio clínico para muitas condições da mão e do braço. Se você está pensando em usar, pergunte ao seu médico o que as evidências dizem sobre o seu problema específico.

Quais são os riscos?

A resposta honesta é que os riscos dependem da sua situação, e as pesquisas não cobrem todos os casos. Para a dor nos nervos dos membros, uma revisão constatou que os medicamentos à base de cannabis podem ajudar [11]. Mas, para a dor nos nervos após lesões do plexo braquial (uma lesão por estiramento dos nervos que vão do pescoço até o braço), ensaios clínicos não encontraram benefício clinicamente importante quando o tratamento à base de cannabis foi acrescentado aos planos habituais de alívio da dor [5].

Em relação à cirurgia, o quadro é misto. O CBD pode ser incluído em um plano combinado de alívio da dor após o reparo do manguito rotador por vídeo sem prejudicar a sua recuperação a curto ou longo prazo [12, 13]. Um estudo com CBD absorvido pela mucosa da bochecha constatou que ele foi bem tolerado e reduziu a dor nos primeiros dias após essa mesma operação [17]. Mas, entre adolescentes submetidos a reconstrução de ligamento do joelho, os que relataram uso de maconha precisaram de internação durante a noite por causa da dor com mais frequência e demoraram mais para voltar ao esporte [15]. Pessoas com dependência de cannabis documentada tiveram maior probabilidade de problemas na ferida após cirurgias de partes moles da mão e do punho [8].

Entre adolescentes e adultos jovens submetidos a cirurgia do quadril por vídeo, os que usavam maconha antes da cirurgia tiveram os mesmos níveis de dor, a mesma necessidade de analgésicos e a mesma recuperação que os que não usavam [14]. Os pesquisadores também avaliaram se combinar cannabis com nicotina alterava o risco de problemas após a cirurgia de fraturas do membro superior. Não encontraram um efeito adicional claro, mas observam que o estudo pode não ter sido grande o suficiente para detectar um efeito pequeno [18].

Há lacunas reais no que se sabe. Um estudo constatou que o uso de cannabis não afetou os resultados após a cirurgia de prótese de quadril, embora os seus autores digam que ainda são necessários mais estudos [10]. Os pesquisadores também dizem que são necessários mais estudos para muitas condições da mão e do braço [9, 4]. Portanto, se você usa cannabis ou CBD, informe o seu médico. Ele pode ponderar o que as evidências dizem sobre a sua operação ou condição específica, e o que elas ainda não dizem.

Este tratamento é adequado para você?

Não há um simples sim ou não aqui. Pode valer a pena considerar os medicamentos à base de cannabis para dores de longa duração nos músculos, ossos e nervos, em que uma revisão relatou que as evidências atuais sugerem benefício e segurança [4]. Eles também podem ajudar na dor nos nervos dos membros, fora da coluna [11]. Mas, para muitas condições da mão e do braço, ainda não há bons ensaios clínicos, então ninguém pode dizer com certeza se eles vão ajudar você [9, 4].

Em relação à cirurgia, a resposta depende da sua operação e do seu histórico. O CBD pode fazer parte de um plano combinado de alívio da dor após o reparo do manguito rotador por vídeo sem prejudicar a sua recuperação [12, 13]. Mas, se você usou cannabis com regularidade, há alguns cuidados. O uso regular foi associado a um maior consumo de opioides após a cirurgia de prótese articular [7]. E pessoas com dependência de cannabis documentada tiveram maior probabilidade de problemas na ferida após cirurgias de partes moles da mão e do punho [8]. Adolescentes submetidos a reconstrução de ligamento do joelho que relataram uso de maconha precisaram de internação durante a noite por causa da dor com mais frequência e demoraram mais para voltar ao esporte [15].

Em comparação com os planos habituais de alívio da dor, os medicamentos à base de cannabis não são um substituto. Para a dor nos nervos após lesões do plexo braquial (uma lesão por estiramento dos nervos que vão do pescoço até o braço), ensaios clínicos não encontraram benefício clinicamente importante quando eles foram acrescentados ao tratamento habitual [5]. Uma forma sintética de THC não pareceu reduzir o consumo de opioides após a cirurgia de prótese de joelho [6].

A seção sobre riscos acima explica os cuidados com mais detalhes. Se você está pensando em experimentar, converse primeiro com o seu médico. Ele pode ponderar o que as evidências dizem sobre o seu problema específico, e o que elas ainda não dizem. Esta deve ser uma decisão compartilhada entre você e o seu médico.

Conclusão

Pode valer a pena considerar os medicamentos à base de cannabis para dores de longa duração nos músculos, ossos e nervos, em que uma revisão relatou que as evidências atuais sugerem benefício e segurança [4]. Em relação à cirurgia, o CBD pode fazer parte de um plano combinado de alívio da dor após o reparo do manguito rotador por vídeo sem prejudicar a sua recuperação a curto ou longo prazo [12, 13]. Mas a mesma substância pode parecer inofensiva em uma situação e problemática em outra, portanto as evidências dependem da sua condição ou operação específica. A ressalva mais importante: informe o seu médico se você usa cannabis ou CBD, para que ele possa ponderar o que as pesquisas dizem sobre a sua situação, e o que elas ainda não dizem.

Referências

[1] 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

[2] 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

[3] 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

[4] 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

[5] 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

[6] 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

[7] 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

[8] 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

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

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

[11] 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

[12] 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

[13] 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

[14] No Evidence That Preoperative Marijuana Use Influences the Success of Hip Arthroscopy for Femoracetabular Impingement in Adolescents and Young Adults. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/23259671251385152

[15] Effect of Marijuana Use on Pain Management and Return to Sport After Anterior Cruciate Ligament Reconstruction in Pediatric and Adolescent Patients: A Matched Control Study. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/23259671251369015

[16] Poster 189. Cannabis Use in Patients Undergoing Sports Medicine Procedures and Post-Operative Pain Scores. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/2325967126s00487

[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] Cannabis and nicotine use are independently associated with adverse surgical, medical, and psychosocial outcomes following upper extremity fracture fixation. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-025-06635-w


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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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.


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