Indomethacin versus meloxicam for prevention of heterotopic ossification after total hip arthroplasty

Legenstein, R.; Bösch, Peter; Ungersböck, A.

doi:10.1007/s00402-003-0487-y

Cited by 34 publications

(22 citation statements)

References 26 publications

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“…In recent years, more COX-2 selective inhibitors have been developed with fewer side effects (Bombardier et al 2000, Feldman and McMahon 2000, Laine 2002, Gajraj 2003) and the same pain-reducing effects (Degner et al 1998, Schoenfeld 1999, Feldman and McMahon 2000. The effect on HO of this newer class of NSAIDs is described circumstantially: the effect of meloxicam is contrasting; some studies have shown the same effect (Legenstein et al 2003, van der Heide et al 2004, while another showed inferior results (Barthel et al 2002). The effect of celecoxib has been described by Romano et al (2004), and is comparable to the effect of indomethacin.…”

Section: Discussionmentioning

confidence: 99%

Similar effects of rofecoxib and indomethacin on the incidence of heterotopic ossification after hip arthroplasty

et al. 2007

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Background Although indomethacin is effective in preventing heterotopic ossification (HO) after primary total hip arthroplasty, side effects are frequently observed. In the last decade a new class of drugs-the COX-2 selective nonsteroidal anti-inflammatory drugs-has been developed. To investigate the effect of these COX-2 selective NSAIDs on heterotopic ossification (HO) after primary total hip arthroplasty (THA), we conducted a randomized controlled trial using either indomethacin or rofecoxib for 7 days.Methods 186 patients received either indomethacin 3 times daily, or rofecoxib twice, and 1 placebo, daily for 7 days. HO was graded according to the 1-year postoperative radiographs according to the Brooker classification.Results 12 of the 186 patients included discontinued their medication before the end of the trial due to side effects. The remaining 174 patients were included in the analysis. In the indomethacin group (n = 89), 77 patients (87%) showed no HO, 9 showed HO of grade 1 and 3 showed HO of grade 2 according to the Brooker classification. In the rofecoxib group (n = 85) 73 patients (86%) showed no ossification, 9 showed grade 1, and 3 showed grade 2.Interpretation The prophylactic effect of rofecoxib for 7 days in preventing heteropic ossification after primary total hip arthroplasty is comparable to the effect of indomethacin given for 7 days. These results indicate that the development of HO follows a COX-2 pathway.

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Section: Discussionmentioning

confidence: 99%

Similar effects of rofecoxib and indomethacin on the incidence of heterotopic ossification after hip arthroplasty

et al. 2007

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“…[1][2][3] The exact mechanism responsible for each of these pathologic new bone formations is not clear. 4,5 Various medications, e.g., aspirin, indomethacin, diclofenac, and radiation protocols with 500 rads to 1,000 rads of radiation have been tried especially after hip arthroplasty to decrease the occurrence and implications of heterotopic ossification. 6,7 These treatment modalities have side effects and complications.…”

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Levothyroxin Inhibits Heterotopic Ossification: An Experimental Study in Rabbits

Namazi

Mozaffarian

2008

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…1,7,18 However, in the present study, no relationship was found between the 2 variables. Studies of total hip replacement have reported that NSAIDs may prevent HO, 8,10,17,34 but the actual effect of NSAIDs in cervical arthroplasty on HO has not been determined. In the present study, we encountered a high rate of HO, despite routinely administering NSAIDs for more than 2 weeks following surgery, which casts doubts on the idea of HO prevention using NSAIDs.…”

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Radiological changes of the operated and adjacent segments following cervical arthroplasty after a minimum 24-month follow-up: comparison between the Bryan and Prodisc-C devices

Ryu¹,

Park²,

Jun³

et al. 2010

SPI

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Object. The purposes of this retrospective study were to determine the radiological changes at the index and adjacent levels after cervical arthroplasty using the Bryan disc and Prodisc-C disc after a minimum 24 months followup, and to demonstrate the possible clinical factors related to these changes. Methods. Following single-level cervical arthroplasty using either the Bryan disc or Prodisc-C, the degree of facet degeneration and other radiological changes at the index and adjacent levels were assessed by observing radiographs and CT scans at a minimum 24 months after the operations. These findings were determined in relation to the clinical outcome, various perioperative factors, and prosthesis factors. Thirty-six patients were included in this investigation (19 in the Bryan disc group and 17 in the Prodisc-C group).Results. At the index level, progression of facet arthrosis (PFA) was observed in 7 of 36 levels (1 level with the Bryan disc, 6 with the Prodisc-C). At adjacent levels, PFA was minimally observed. Heterotopic ossification (HO) was observed at 19 levels (11 with the Bryan disc, 8 with Prodisc-C). Progression of facet arthrosis at the index segments was positively related to malposition of the prosthesis on the frontal plane, and decreased postoperative functional spinal unit range of motion at the index level. Occurrence of HO was correlated with the preoperative calcification of the posterior longitudinal ligament at the operated level, regardless of prosthesis type. Clinical outcome and the occurrence of PFA or HO did not show any significant relationship.Conclusions. This study demonstrates that the incidence of PFA at the index level is 19.4% after a minimum 24-month follow-up, and occurs more frequently in the Prodisc-C group. Progression of facet arthrosis is related to less functional spinal unit range of motion and anterior placement of the prosthesis. The occurrence rate of HO is high, regardless of the type of prosthesis, and it is significantly correlated with preoperative calcification of the posterior longitudinal ligament at the operated level. (DOI: 10.3171/2010.3.SPINE09445) Key WoRDS

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Indomethacin versus meloxicam for prevention of heterotopic ossification after total hip arthroplasty

Cited by 34 publications

References 26 publications

Similar effects of rofecoxib and indomethacin on the incidence of heterotopic ossification after hip arthroplasty

Similar effects of rofecoxib and indomethacin on the incidence of heterotopic ossification after hip arthroplasty

Levothyroxin Inhibits Heterotopic Ossification: An Experimental Study in Rabbits

Radiological changes of the operated and adjacent segments following cervical arthroplasty after a minimum 24-month follow-up: comparison between the Bryan and Prodisc-C devices

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