Selective COX-2 inhibitor versus indomethacin for the prevention of heterotopic ossification after hip replacement: a double-blind randomized trial of 100 patients with 1-year follow-up.

Abstract

INTRODUCTION:

Recent reports have suggested that selective COX-2 inhibition may be sufficient for the prevention of heterotopic ossification.

METHODS:

We performed a randomized controlled study to evaluate the effect of the selective COX-2 inhibitor rofecoxib compared to that of indomethacin on the incidence and extent of heterotopic ossification in patients who had undergone hip replacement surgery. 50 patients received a daily dose of 25 mg rofecoxib and 50 patients received a daily dose of 100 mg indomethacin (25, 25, and 50 mg).

RESULTS:

No ossifications were found in 48 patients. Grade-II ossifications were seen in 5/46 patients in the rofecoxib group and in 6/50 patients in the indomethacin group. Grade-III and grade-IV ossifications were seen in 3/46 patients in the rofecoxib group only. The differences were not statistically significant. The study medication had to be discontinued in 2 patients in the indomethacin group, due to dyspepsia.

INTERPRETATION:

After short-term administration, the selective COX-2 inhibitor rofecoxib was effective in preventing heterotopic ossification after total hip arthroplasty.

• Authors: Josef G Grohs, Maximilian Schmidt, Axel Wanivenhaus
• Journal: Acta orthopaedica (Acta Orthop) Vol. 78 Issue 1 Pg. 95-8 (Feb 2007) ISSN: 1745-3674 [Print] Sweden
• PMID: 17453399 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Cyclooxygenase 2 Inhibitors
• Lactones
• Sulfones
• rofecoxib
• Indomethacin

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anti-Inflammatory Agents, Non-Steroidal (administration & dosage, adverse effects)
• Arthroplasty, Replacement, Hip (adverse effects)
• Cyclooxygenase 2 Inhibitors (administration & dosage, adverse effects)
• Double-Blind Method
• Female
• Follow-Up Studies
• Humans
• Indomethacin (administration & dosage, adverse effects)
• Lactones (administration & dosage, adverse effects)
• Male
• Middle Aged
• Ossification, Heterotopic (etiology, prevention & control)
• Sulfones (administration & dosage, adverse effects)