Do Selective COX-2 Inhibitors Affect Pain Control and Healing After Arthroscopic Rotator Cuff Repair? A Preliminary Study

Oh, Joo Han; Seo, Hyuk Jun; Lee, Ye Hyun; Choi, Hye Yeon; Joung, Ho Yun; Kim, Sae Hoon

doi:10.1177/0363546517744219

Cited by 59 publications

(53 citation statements)

References 41 publications

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“…However, adverse side effects caused by oral medications are an annoying problem. Opioid drugs could result in nausea, sedation, constipation, vomiting, and respiratory depression [ 8 ]. On the other hand, due to inhibition of cyclooxygenase (COX)-1 and disturbance of platelet function, traditional nonselective NSAIDs might lead to gastrointestinal toxicity and bleeding [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Do Nonsteroidal Anti-Inflammatory Drugs Affect Tissue Healing After Arthroscopic Anterior Cruciate Ligament Reconstruction?

Liu

Shrestha³

et al. 2018

Med Sci Monit

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BackgroundExperimental studies have reported nonsteroidal anti-inflammatory drugs (NSAIDs) could impair tendon healing. The purpose of this study was to investigate whether NSAIDs could affect recovery of knee joint function in patients after anterior cruciate ligament (ACL) reconstruction.Material/MethodsWe enrolled 40 patients treated with celecoxib and 40 patients treated with tramadol, who underwent ACL reconstruction from January 2011 to December 2017. Visual analogue scale (VAS) and functional outcomes were collected and evaluated. The follow-up period was 12 months.ResultsIn both groups, all patients obtained pain release after surgery, compared with that before surgery. But no significant differences were observed between the 2 groups in VAS scores. We also did not find any differences between the 2 groups at 1 year of follow-up, in terms of anterior drawer test, Lachman test, side-to-side laxity assessed by KT-2000, IKDC score, Lysholm score, and Tegner scale. However, the celecoxib group showed a reduced incidence of nausea compared to the tramadol group (P=0.048).ConclusionsThe use of NSAIDs after ACL reconstruction is relatively safe and could decrease adverse side effects which were caused by opioid drugs.

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Section: Introductionmentioning

confidence: 99%

Do Nonsteroidal Anti-Inflammatory Drugs Affect Tissue Healing After Arthroscopic Anterior Cruciate Ligament Reconstruction?

Liu

Shrestha³

et al. 2018

Med Sci Monit

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“…Soreide et al 24 used diclofenac, ketorolac, celecoxib, or another NSAID for a mean of 6.7 days but did not report the dosage. Oh et al 21 compared celecoxib (200 mg twice a day) versus ibuprofen (385 mg 3 times a day) administered for 14 days after treatment. Blomquist et al 3 did not report the specific NSAID used or the dosage but noted that the NSAID was administered for an interval ranging from 1 to 7 days postoperatively.…”

Section: Resultsmentioning

confidence: 99%

“…The reported surgical failure rate among control participants who were not given NSAIDs was 3.7% (147/3996). Surgical failure rates among patients administered NSAIDs for each procedure were as follows: meniscal repair, 34% (11/32) 22 ; ACL reconstruction, 3% (127/4144) 24 ; rotator cuff repair, 23% (celecoxib 11/30 and ibuprofen 2/27) 21 ; and Bankart repair, 5% (6/127). 3 NSAID use showed no statistically significant effect on need for reoperation after meniscal repair ( P = .99), ACL reconstruction ( P = .8), and Bankart repair ( P = .8) compared with no NSAID administration.…”

Section: Resultsmentioning

confidence: 99%

Effects of Perioperative Nonsteroidal Anti-inflammatory Drug Administration on Soft Tissue Healing: A Systematic Review of Clinical Outcomes After Sports Medicine Orthopaedic Surgery Procedures

Constantinescu

Campbell

Moatshe

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: The effects of perioperative nonsteroidal anti-inflammatory drugs (NSAIDs) on soft tissue healing in humans have yet to be established. Purpose: To systematically review the literature addressing the effects of perioperative NSAID administration on soft tissue healing and clinical patient outcomes. Study Design: Systematic review; Level of evidence, 3. Methods: This review study was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. A review of the literature regarding the existing evidence for clinical effects of NSAID use on soft tissue healing was performed through use of the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed (1980 to present), and MEDLINE. Inclusion criteria for articles were as follows: outcome studies after soft tissue (ligament, meniscus, tendon, muscle) healing after surgical procedure with perioperative NSAID administration, at least 1 year of follow-up, English language, and human participants. Results: A total of 466 studies were initially retrieved, with 4 studies satisfying all inclusion criteria. Among the surgical procedures reported, 93% of the patients (4144/4451) underwent anterior cruciate ligament (ACL) reconstruction, 3% (120/4451) underwent rotator cuff repair, 3% (155/4451) underwent Bankart shoulder repair, and 1% (32/4451) underwent meniscal repair. The reported surgical failure rate among patients administered NSAIDs was 3.6% (157/4360). The reported surgical failure rate among control participants not given NSAIDs was 3.7% (147/3996). NSAID use showed no statistically significant effect on need for reoperation in meniscal repair ( P = .99), ACL reconstruction ( P = .8), and Bankart repair ( P = .8) compared with no NSAID administration. Celecoxib administration had a significantly higher rate of retear (37%) after rotator cuff repair compared with ibuprofen (7%) ( P = .009). Conclusion: Insufficient data are available to definitively state the effects of perioperative NSAIDs on soft tissue healing. Use of NSAIDs should be considered on a case-by-case basis and may not affect healing rates following either meniscal, ACL, rotator cuff, or Bankart repair. However, celecoxib (a selective COX-2 inhibitor) may inhibit tendon-to-bone healing in rotator cuff repair. Further research through clinical trials is required to fully determine whether NSAIDs have an adverse effect on soft tissue healing.

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“…Of note, selective COX-2 inhibitors were associated with fewer gastrointestinal side effects than non-selective COX-2 inhibitor. A preliminary study by Oh et al [36], the efficacy of a selective COX-2 inhibitor in early postoperative pain control, pain management satisfaction level, and incidence of systemic adverse effects in patients undergoing arthroscopic rotator cuff repair were evaluated. This study concluded that, although the selective COX-2 inhibitors have similar postoperative analgesic effects as other nonsteroidal anti-inflammatory drugs and opioids, they might negatively affect tendon-to-bone healing after surgical repair, and thus, they should not be used for postoperative analgesia.…”

Section: Discussionmentioning

confidence: 99%

The efficacy and safety of selective COX-2 inhibitors for postoperative pain management in patients after total knee/hip arthroplasty: a meta-analysis

et al. 2020

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Background: Many selective cyclooxygenase (COX-2) inhibitors are currently used in clinical practice. COX-2 inhibitors have good anti-inflammatory, analgesic, antipyretic effects, and gastrointestinal safety. However, the analgesic effects and adverse reactions of COX-2 after total knee/hip arthroplasty (TKA/THA) are not fully known. Objective: To evaluate the efficacy and safety of selective COX-2 inhibitors in postoperative pain management in patients receiving TKA/THA. Methods: Randomized controlled trials (RCTs) were retrieved from medical literature databases. Risk ratios (RR) Std mean difference (SMD) and 95% confidence intervals (CI) were calculated to analyze the primary and safety endpoints. Results: In total, 18 articles (23 trial comparisons) were retrieved comprising 3104 patients. Among them, 1910 patients (61.5%) were randomized to the experimental group whereas 1194 patients (38.5%) were randomized to the control group. The primary endpoints were the patients' VAS score at rest or on ambulation (within 3 days). We found that VAS score in patients that received selective COX-2 inhibitor was significantly lower compared to those of the control group. Conclusion: This meta-analysis shows that selective COX-2 inhibitor therapy is effective, safe, and reliable in relieving postoperative pain of THA/TKA.

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Do Selective COX-2 Inhibitors Affect Pain Control and Healing After Arthroscopic Rotator Cuff Repair? A Preliminary Study

Cited by 59 publications

References 41 publications

Do Nonsteroidal Anti-Inflammatory Drugs Affect Tissue Healing After Arthroscopic Anterior Cruciate Ligament Reconstruction?

Do Nonsteroidal Anti-Inflammatory Drugs Affect Tissue Healing After Arthroscopic Anterior Cruciate Ligament Reconstruction?

Effects of Perioperative Nonsteroidal Anti-inflammatory Drug Administration on Soft Tissue Healing: A Systematic Review of Clinical Outcomes After Sports Medicine Orthopaedic Surgery Procedures

The efficacy and safety of selective COX-2 inhibitors for postoperative pain management in patients after total knee/hip arthroplasty: a meta-analysis

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