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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

Development of range of motion during follow-up (mean ± SD): extension placebo, flexion placebo, extension celecoxib, flexion celecoxib.
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Figure 0004: Development of range of motion during follow-up (mean ± SD): extension placebo, flexion placebo, extension celecoxib, flexion celecoxib.

Mentions: Range of knee motion increased at the same rate in both groups, to the same total motion segment (flexion minus extension) (placebo: 121 degrees (SD 13); celecoxib: 123 degrees (SD 13); 95% CI: –10 to 6) (Figure 4).


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)

Development of range of motion during follow-up (mean ± SD): extension placebo, flexion placebo, extension celecoxib, flexion celecoxib.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0004: Development of range of motion during follow-up (mean ± SD): extension placebo, flexion placebo, extension celecoxib, flexion celecoxib.
Mentions: Range of knee motion increased at the same rate in both groups, to the same total motion segment (flexion minus extension) (placebo: 121 degrees (SD 13); celecoxib: 123 degrees (SD 13); 95% CI: –10 to 6) (Figure 4).

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