{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:20:33Z","timestamp":1777612833047,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Orthopaedics"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The purpose of this study was to investigate the association between cannabis use and postoperative complications following ankle and hindfoot arthrodesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cohort study using a large national insurance database from 2010 to 2022 was conducted. All patients who underwent ankle or hindfoot arthrodesis with at least 2 years\u2019 follow-up were included. Patients were divided into 4 groups: cannabis-only users, tobacco-only users, cannabis and tobacco users, and nonuser controls. Groups were matched 1:4 with nonuser controls based on demographic variables and comorbidities. Also, both cannabis and tobacco users were matched 1:4 with tobacco-only users based on demographics and comorbidities. Medical complications within 90\u2009days of surgery and surgery-specific complications within 2\u2009years were compared between groups with multivariable logistic regressions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Compared with nonuser controls, cannabis users only were not at increased risk of 90-day medical complications or 2-year surgical complications. Tobacco use alone was associated with increased risk of postoperative admission (OR 1.32, 95% CI 1.21-1.43) and emergency department (ED) utilization (OR 1.57, 95% CI 1.48-1.66) within 90\u2009days as well as infection (OR 1.24, 95% CI 1.18-1.30), hardware removal (OR 1.12, 95% CI 1.07-1.18), nonunion (OR 1.33, 95% CI 1.27-1.40), and wound dehiscence (OR 1.38, 95% CI 1.27-1.49) within 2\u2009years of surgery compared with nonuser controls. Compared with tobacco-only use, combined cannabis and tobacco use was associated with increased risk of ED visits within 90\u2009days (OR 1.45, 95% CI 1.30-1.62) and nonunion within 2\u2009years of surgery (OR 1.19, 95% CI 1.05-1.35).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>These findings suggest that although cannabis use alone was not associated with a higher risk of postoperative complications, its concurrent use with tobacco was linked to greater rates of adverse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, retrospective case control study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24730114251328669","type":"journal-article","created":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T00:22:06Z","timestamp":1744417326000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The Association of Cannabis and Tobacco Use With Postoperative Complications after Ankle and Hindfoot Arthrodesis"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1936-9155","authenticated-orcid":false,"given":"Alejandro M.","family":"Holle","sequence":"first","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Phoenix AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan C.","family":"Beckett","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Phoenix AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose M.","family":"Iturregui","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8190-7795","authenticated-orcid":false,"given":"Jack M.","family":"Haglin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd A.","family":"Kile","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2009.12.003"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xnsj.2023.100265"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2019.3254"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.bot.0000211156.13487.6a"},{"key":"e_1_3_3_6_2","unstructured":"Chapekis A Shah S. Most Americans now live in a legal marijuana state\u2014and most have at least one dispensary in their county. Pew Research Center. February 29 2024. Accessed July 18 2024. https:\/\/www.pewresearch.org\/short-reads\/2024\/02\/29\/most-americans-now-live-in-a-legal-marijuana-state-and-most-have-at-least-one-dispensary-in-their-county\/"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.sart.2023.01.003"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110079401500202"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2021.108448"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/10711007231189698"},{"key":"e_1_3_3_11_2","unstructured":"Gallup Inc. Tobacco and smoking. Gallup.com. August 9 2007. Accessed January 1 2025. https:\/\/news.gallup.com\/poll\/1717\/Tobacco-Smoking.aspx"},{"key":"e_1_3_3_12_2","unstructured":"Gallup Inc. What percentage of Americans smoke marijuana? Gallup.com. November 1 2024. Accessed January 1 2025. https:\/\/news.gallup.com\/poll\/284135\/percentage-americans-smoke-marijuana.aspx"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.7517"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2011.0940"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.86.BJR-2018-0344.R1"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682221093965"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.3109\/10408449009089870"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1615\/JLongTermEffMedImplants.2018027401"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2024.12.002"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-023-06992-4"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/24730114211040740"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2007.08.004"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0504187103"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110079902000805"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.2403"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.imbio.2009.04.001"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.00081"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31824f632d"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1124\/mol.106.026435"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1136\/tc.2005.015263"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2009.07.002"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.07.008"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.11.035"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.OA.20.00157"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.01.035"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.05.041"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-21-00703"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1177\/10711007241238213"}],"container-title":["Foot &amp; Ankle Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24730114251328669","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/24730114251328669","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24730114251328669","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:24:09Z","timestamp":1777411449000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/24730114251328669"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":37,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1177\/24730114251328669"],"URL":"https:\/\/doi.org\/10.1177\/24730114251328669","relation":{},"ISSN":["2473-0114","2473-0114"],"issn-type":[{"value":"2473-0114","type":"print"},{"value":"2473-0114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"article-number":"24730114251328669"}}