Cannabinoids in Orthopedics

Cannabis sativa derivatives, or cannabinoids, are making their way into many of our pain strategies. Cannabidiol (CBD) is the most popular because of the lack of psychotropic effects. Deckey et al. found a 25 percent prevalence of CBD use in patients with hip and knee osteoarthritis treated non-operatively.

MOA

Cannibinoids function on endocannabinoid systems and have an antagonistic effect on Cannbinoid receptor 1 and 2 (CB1, CB2). CB2 receptors are found on immune cells which represents one theory on why CBD acts as an anti-inflammatory agent. A recent review concluded that the effectiveness of cannabinoids as a therapeutic agent remains ambiguous.

CBD + foot and ankle

No published literature exists in the foot and ankle space with Cannabinoids. Perhaps the one study that may translate to foot and ankle is topical application of (1)CBD cream vs. (2)shea butter without CBD for basal thumb OA. Results from this study showed statistically significant improvement in visual analog scale for pain favoring the CBD cream.

Buyer beware

Cannibinoids remain generally unregulated; there is no designated medical grade and dose concentrations are variable.