Dose-dependent efficacy of diclofenac-cholestyramine on pain and periarticular ossifications after total hip arthroplasty: a double-blind, prospective, randomised trial

Abstract

Treatment with a dose of 75 mg diclofenac once daily-if necessary with the additional use of paracetamol-is a favourable option for the postoperative care of THA.

Reducing the Pain: A Systematic Review of Postdischarge Analgesia Following Elective Orthopedic Surgery

“…Two studies investigated diclofenac use following knee arthroscopy [39] and hip arthroplasty [40]. Nelson et al.…”

“…Handel et al. [40] investigated two strengths of diclofenac (75 and 150 mg) and found that the higher dose further reduced pain and rescue analgesia use after 14 days only. The higher dose resulted in a higher incidence of side effects compared with a placebo, although all withdrawals were independent of analgesic intervention.…”

Prevention of heterotopic ossification in high-risk patients with total hip arthroplasty: the experience of a combined therapeutic protocol

“…On the other hand, NSAIDs have been extensively used perioperatively for the prevention of HO after THA. Several types of NSAID in different daily doses and durations of treatment have been employed with varying success in the reported outcomes [4,7,19,24]. Several randomised trials have compared the efficacy of RT and NSAIDs [12,16].…”

“…RT can be given either postoperatively within 3 days of surgical treatment or preoperatively a few hours before surgery with varying results reported [1,8,14]. Moreover, NSAIDs, especially indomethacin, have been extensively used for the prevention of HO in various daily doses and durations of therapy [7,18,19]. However, despite the widespread use of both therapies, the type of therapy, the dose, and the duration of treatment have not yet been well established.…”

Πρόληψη Της Έκτοπης Οστεοποίησης Μετά Από Ολική Αρθροπλαστική Του Ισχίου

“…Η δράση τους αυτή µάλιστα διαρκεί µόνο για το διάστηµα που χορηγούνται και µετά τη διακοπή τους η οστεοποίηση συνεχίζει σε κανονικό ρυθµό[26].Τα ΜΣΑΦ αποτελούν, µαζί µε την ακτινοθεραπεία, τις 2 βασικές θεραπευτικές επιλογές στην πρόληψη της ΕΟ. Τα ΜΣΑΦ έχουν αποδειχθεί αποτελεσµατικά στην πρόληψη της ΕΟ[14,[88][89][90][91]. Η δράση των συγκεκριµένων φαρµάκων είναι διπλή: έχουν µια άµεση δράση εµποδίζοντας τη διαφοροποίηση των µεσεγχυµατικών κυττάρων σε οστεοκύτταρα, και µια έµµεση δράση, µέσω της παρεµπόδισης της µετατραυµατικής οστικής ανακατασκευής (bone remodeling), καταστέλλοντας την ρυθµιζόµενη µε τη διαµεσολάβηση των προσταγλανδινών (συγκεκριµένα της προσταγλανδίνης Ε2) ανταπόκριση[23,26].…”