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Celecoxib does not appear to affect prosthesis fixation in total knee replacement: A randomized study using radiostereometry in 50 patients.

Meunier A, Aspenberg P, Good L - Acta Orthop (2009)

Bottom Line: Cox-2 inhibitors are widely used as postoperative analgesics, and have adverse effects on bone healing.Confidence intervals were narrow.It is unlikely that Celecoxib increases the risk of loosening, and it may be used safely in conjunction with TKR.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopedics, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden. andreas.meunier@lio.se

ABSTRACT

Background and purpose: After joint replacement, a repair process starts at the interface between bone and cement. If this process is disturbed, the prosthesis may never become rigidly fixed to the bone, leading to migration-and with time, loosening. Cox-2 inhibitors are widely used as postoperative analgesics, and have adverse effects on bone healing. This could tamper prosthesis fixation. We investigated whether celecoxib, a selective Cox-2 inhibitor, increases prosthesis migration in total knee replacement (TKR).

Methods: 50 patients were randomized to either placebo or celecoxib treatment, 200 mg twice daily, for 3 weeks after TKR (NexGen; Zimmer). Maximum total point motion (MTPM) of the tibial component was measured after 2 years using radiostereometric analysis (RSA). In addition, range of motion, pain, and, subjective outcome were evaluated.

Results: No differences in prosthesis migration, pain scores, range of motion, and subjective outcome were found after 2 years. Confidence intervals were narrow.

Interpretation: It is unlikely that Celecoxib increases the risk of loosening, and it may be used safely in conjunction with TKR.

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Related in: MedlinePlus

MTPM between 1 and 2 years.
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Figure 0002: MTPM between 1 and 2 years.

Mentions: The MTPM at 2 years was similar in both groups (celecoxib: 0.35 mm (0.17), placebo: 0.4 mm (0.15), CI for group difference –0.15 to 0.04) (Figure 1). The calculated confidence interval for the primary endpoint indicates that any real difference in outcome between the groups, with 95% confidence, is less than the pre-specified minimal clinically relevant value. No significant differences of rotation and translation values were found between the two groups (Table 2). Migration (MTPM) between 1 and 2 years was 0.23 mm (0.18) in the celecoxib group and 0.2 mm (0.07) in the placebo group (CI for group difference –0.5 to 0.1). There were a few more outliers in the celecoxib group (Figure 2). The conditioning number for the prosthesis segment was 21 (10) and for the reference segment 20 (5). The mean error of rigid body fitting for the prosthesis segment was 0.11 (0.05) and for the reference segment 0.17 (0.08).


Celecoxib does not appear to affect prosthesis fixation in total knee replacement: A randomized study using radiostereometry in 50 patients.

Meunier A, Aspenberg P, Good L - Acta Orthop (2009)

MTPM between 1 and 2 years.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2823240&req=5

Figure 0002: MTPM between 1 and 2 years.
Mentions: The MTPM at 2 years was similar in both groups (celecoxib: 0.35 mm (0.17), placebo: 0.4 mm (0.15), CI for group difference –0.15 to 0.04) (Figure 1). The calculated confidence interval for the primary endpoint indicates that any real difference in outcome between the groups, with 95% confidence, is less than the pre-specified minimal clinically relevant value. No significant differences of rotation and translation values were found between the two groups (Table 2). Migration (MTPM) between 1 and 2 years was 0.23 mm (0.18) in the celecoxib group and 0.2 mm (0.07) in the placebo group (CI for group difference –0.5 to 0.1). There were a few more outliers in the celecoxib group (Figure 2). The conditioning number for the prosthesis segment was 21 (10) and for the reference segment 20 (5). The mean error of rigid body fitting for the prosthesis segment was 0.11 (0.05) and for the reference segment 0.17 (0.08).

Bottom Line: Cox-2 inhibitors are widely used as postoperative analgesics, and have adverse effects on bone healing.Confidence intervals were narrow.It is unlikely that Celecoxib increases the risk of loosening, and it may be used safely in conjunction with TKR.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopedics, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden. andreas.meunier@lio.se

ABSTRACT

Background and purpose: After joint replacement, a repair process starts at the interface between bone and cement. If this process is disturbed, the prosthesis may never become rigidly fixed to the bone, leading to migration-and with time, loosening. Cox-2 inhibitors are widely used as postoperative analgesics, and have adverse effects on bone healing. This could tamper prosthesis fixation. We investigated whether celecoxib, a selective Cox-2 inhibitor, increases prosthesis migration in total knee replacement (TKR).

Methods: 50 patients were randomized to either placebo or celecoxib treatment, 200 mg twice daily, for 3 weeks after TKR (NexGen; Zimmer). Maximum total point motion (MTPM) of the tibial component was measured after 2 years using radiostereometric analysis (RSA). In addition, range of motion, pain, and, subjective outcome were evaluated.

Results: No differences in prosthesis migration, pain scores, range of motion, and subjective outcome were found after 2 years. Confidence intervals were narrow.

Interpretation: It is unlikely that Celecoxib increases the risk of loosening, and it may be used safely in conjunction with TKR.

Show MeSH
Related in: MedlinePlus