Naproxen in the Prevention of Heterotopic Ossification After Total Hip Replacement

Vielpeau, C.; Joubert, Jean-Michel; Hulet, Christophe

doi:10.1097/00003086-199912000-00029

Cited by 59 publications

(32 citation statements)

References 24 publications

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“…Since it was demonstrated that the incidence of postoperative recurrent osteophytes was significantly lower in the fused intervertebral segments, from 1998, we started to add cervical fusions to the simple resection procedures of the osteophytes for patients under 70 years of age. Additionally, since NSAIDS has a preventive effect on heterotopic ossification [17], application of NSAIDS might have a preventive effect on postoperative recurrence of osteophytes especially in patients, who are operated, but not fused. We speculate that the long-term follow-up of those patients would provide a new clue to the prevention of the recurrence of osteophytes in the future.…”

Section: Discussionmentioning

confidence: 99%

Postsurgical recurrence of osteophytes causing dysphagia in patients with diffuse idiopathic skeletal hyperostosis

et al. 2009

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Although cervical anterior osteophytes accompanying diffuse idiopathic skeletal hyperostosis (DISH) are generally asymptomatic, large osteophytes sometimes cause swallowing disorders. Surgical resection of the osteophyte has been reported to be an effective treatment; however, little study has been given to the recurrences of osteophytes. A prospective study was performed for seven patients who underwent surgical resection of cervical anterior osteophytes for the treatment of recalcitrant dysphagia caused by osteophytes that accompanied DISH. The seven patients were six men and one woman ranging in age from 55 to 78 years (mean age = 65 years). After a mean postoperative follow-up period of 9 years (range: 6-13 years), surgical outcomes were evaluated by symptom severity and plain radiographs of the cervical spine. On all operated intervertebral segments, the effect of postoperative intervertebral mobility (range of movement[1 degree) on the incidence of recurrent osteophytic formation (width [2 mm) was analyzed by Fisher's exact test. Complete relief of the dysphagia was obtained within one month postoperatively in five patients, while it was delayed for 3 months in two patients.All of the patients developed recurrent cervical osteophytic formation, with an average increase rate of approximately 1 mm/year following surgical resection. Of the 20 operated intervertebral segments, the incidence of recurrent osteophytes was significantly higher (P = 0.0013) in the 16 segments with mobility than in the four segments without mobility. Five of the seven patients remained asymptomatic, although radiological recurrence of osteophytes was seen at the final follow-up. The two remaining patients complained of moderate dysphagia 10 and 11 years after surgery, respectively; one of these two required re-operation due to progressive dysphagia 11 years postoperatively. In patients with cervical DISH and dysphagia, surgical resection of osteophytes resulted in a high likelihood of the recurrence of osteophytes. Therefore, attending surgeons should continue to follow these patients postoperatively for more than 10 years in order to assess the regrowth of osteophytes that may contribute to recurrent symptoms.

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Section: Discussionmentioning

confidence: 99%

Postsurgical recurrence of osteophytes causing dysphagia in patients with diffuse idiopathic skeletal hyperostosis

et al. 2009

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“…Therefore, the use of NSAIDs is considered to be therapeutic in osteoporosis and bone loss prevention in older women [61]. Additionally, NSAIDs have been proven to be useful in the prevention of heterotopic ossifi cation following joint replacement and as a prophylactic against heterotopic bone formation in humans and animals [62][63][64][65][66][67][68].…”

Section: Effects Of Non-selective Nsaids On Bone Healingmentioning

confidence: 99%

Effects of cyclooxygenase inhibition on bone, tendon, and ligament healing

Radi

Khan

2005

Inflamm. res.

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Cyclooxygenases (COX-1 and COX-2) catalyze the conversion of arachidonic acid to prostaglandins (PGs). PGs play a significant role in bone metabolism in health and disease. Conventional non-selective, non-steroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors (COXIBs) are widely used in patients with musculoskeletal conditions and as a post-surgical analgesics. Due to their effects on PG synthesis, these drugs have been hypothesized to affect the healing process of bone fractures and orthopedic surgical sites. A variety of experimental models of bone, ligament, and tendon repair have assessed the effects of these selective and non-selective COX inhibitors in animals, but with variable outcomes. At this time, large-scale, robust clinical study data do not exist, limiting the relevant assessment of experimental animal data to humans. Here, we provide a critical review of available data on the role of PGs and the effect of COX inhibitors on bone, tendon, and ligament repair. Collectively, this assessment suggests potential involvement of PGs in the healing process of these tissues via modulation by non-selective NSAIDs and selective COX-2 inhibitors.

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“…It still remains to be determined which NSAID and dosing schedule are ideal for HO prophylaxis in this patient population. Multiple NSAIDs have been shown to reduce the prevalence of HO when given for durations as short as eight days postoperatively 13,14 . Adding indomethacin to naproxen for HO prophylaxis has been reported to reduce the prevalence of HO compared with that after use of naproxen alone, but the use of a stronger NSAID may cause additional side effects 6 .…”

Section: Discussionmentioning

confidence: 99%

Effect of Naproxen Prophylaxis on Heterotopic Ossification Following Hip Arthroscopy

Beckmann

Wylie

Potter

et al. 2015

The Journal of Bone and Joint Surgery-American Volume

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Naproxen in the Prevention of Heterotopic Ossification After Total Hip Replacement

Cited by 59 publications

References 24 publications

Postsurgical recurrence of osteophytes causing dysphagia in patients with diffuse idiopathic skeletal hyperostosis

Postsurgical recurrence of osteophytes causing dysphagia in patients with diffuse idiopathic skeletal hyperostosis

Effects of cyclooxygenase inhibition on bone, tendon, and ligament healing

Effect of Naproxen Prophylaxis on Heterotopic Ossification Following Hip Arthroscopy

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