No difference between two doses of diclofenac in prophylaxis of heterotopic ossifications after total hip arthroplasty.

Abstract

BACKGROUND:

In a monocentric, randomized, placebo-controlled double-blind study, we investigated the efficacy of two doses of diclofenac-cholestyramine for the prevention of heterotopic ossification (HO).

PATIENTS:

The study comprised 245 patients undergoing total hip arthroplasty (THA).

RESULTS:

With 150 mg cholestyramine-bound diclofenac (2 x 1 capsule Voltaren resinate) daily during a postoperative period of 14 days, 19% of patients showed slight HO (Brooker grade 1), and no patient had more severe ossifications (grades 2-4). In the group receiving 75 mg daily (1 x 1 capsule), 17% of patients showed grade 1 HO and 4% grade 2 HO. No patient had grades 3-4 HO. No differences in clinical results were seen between the two groups 6 months after THA.

INTERPRETATION:

Since the rate of adverse gastrointestinal events was lower (23% versus 38%, p = 0.02) in the group receiving the lower dose, we recommend it.

• Authors: Stefan Sell, Oliver Phillips, Martin Handel
• Journal: Acta orthopaedica Scandinavica (Acta Orthop Scand) Vol. 75 Issue 1 Pg. 45-9 (Feb 2004) ISSN: 0001-6470 [Print] England
• PMID: 15022805 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Diclofenac

Topics

• Aged
• Anti-Inflammatory Agents, Non-Steroidal (administration & dosage, adverse effects)
• Arthroplasty, Replacement, Hip (adverse effects)
• Diclofenac (administration & dosage, adverse effects)
• Dose-Response Relationship, Drug
• Double-Blind Method
• Female
• Follow-Up Studies
• Gastrointestinal Diseases (chemically induced)
• Humans
• Male
• Middle Aged
• Ossification, Heterotopic (etiology, prevention & control)
• Severity of Illness Index