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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

Pain during follow-up (median with interquartile range): placebo, celecoxib.
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Figure 0003: Pain during follow-up (median with interquartile range): placebo, celecoxib.

Mentions: No differences were found in pain score, as measured with VAS. Due to skewed distribution, values had to be normalized by logarithmic transformation, which then showed similar means and standard deviations. In absolute values, the placebo group had a median value of 0.2 (interquartile range: 0–1.25) and the celecoxib group had a median value of 0.3 (interquartile range: 0–0.95) (Figure 3).


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)

Pain during follow-up (median with interquartile range): placebo, celecoxib.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0003: Pain during follow-up (median with interquartile range): placebo, celecoxib.
Mentions: No differences were found in pain score, as measured with VAS. Due to skewed distribution, values had to be normalized by logarithmic transformation, which then showed similar means and standard deviations. In absolute values, the placebo group had a median value of 0.2 (interquartile range: 0–1.25) and the celecoxib group had a median value of 0.3 (interquartile range: 0–0.95) (Figure 3).

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