Is etoricoxib effective in preventing heterotopic ossification after primary total hip arthroplasty?

Abstract

PURPOSE:

Heterotopic ossification is a common complication after total hip arthroplasty. Non-steroidal anti-inflammatory drugs (NSAIDs) are known to prevent heterotopic ossifications effectively, however gastrointestinal complaints are reported frequently. In this study, we investigated whether etoricoxib, a selective cyclo-oxygenase-2 (COX-2) inhibitor that produces fewer gastrointestinal side effects, is an effective alternative for the prevention of heterotopic ossification.

METHODS:

We investigated the effectiveness of oral etoricoxib 90 mg for seven days in a prospective two-stage study design for phase-2 clinical trials in a small sample of patients (n = 42). A cemented primary total hip arthroplasty was implanted for osteoarthritis. Six months after surgery, heterotopic ossification was determined on anteroposterior pelvic radiographs using the Brooker classification.

RESULTS:

No heterotopic ossification was found in 62 % of the patients that took etoricoxib; 31 % of the patients had Brooker grade 1 and 7 % Brooker grade 2 ossification.

CONCLUSIONS:

Etoricoxib seems effective in preventing heterotopic ossification after total hip arthroplasty. This finding further supports the use of COX-2 inhibitors for the prevention of heterotopic ossification following total hip arthroplasty.

• Authors: Jaap J Brunnekreef, Paul Hoogervorst, Marieke J Ploegmakers, Wim H Rijnen, Berend W Schreurs
• Journal: International orthopaedics (Int Orthop) Vol. 37 Issue 4 Pg. 583-7 (Apr 2013) ISSN: 1432-5195 [Electronic] Germany
• PMID: 23359100 (Publication Type: Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Cyclooxygenase 2 Inhibitors
• Pyridines
• Sulfones
• Etoricoxib

Topics

• Administration, Oral
• Adult
• Aged
• Aged, 80 and over
• Arthroplasty, Replacement, Hip (adverse effects)
• Cyclooxygenase 2 Inhibitors (administration & dosage, adverse effects, therapeutic use)
• Dose-Response Relationship, Drug
• Etoricoxib
• Female
• Hip Joint (diagnostic imaging, surgery)
• Hip Prosthesis
• Humans
• Male
• Middle Aged
• Ossification, Heterotopic (etiology, prevention & control)
• Osteoarthritis, Hip (surgery)
• Prospective Studies
• Pyridines (administration & dosage, adverse effects, therapeutic use)
• Radiography
• Severity of Illness Index
• Sulfones (administration & dosage, adverse effects, therapeutic use)
• Treatment Outcome