Selective versus non-selective NSAIDs as prophylaxis for heterotopic ossification following hip arthroplasty: a meta-analysis.

Abstract

BACKGROUND:

Some patients have demonstrated evidence of heterotopic ossification (HO) following total hip arthroplasty (THA). Selective and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) are used as prophylaxis for HO following THA. This meta-analysis compared selective versus non-selective NSAIDs as prophylaxis for HO following THA.

MATERIAL AND METHODS:

The present study was conducted according to the PRISMA 2020 guidelines. All the clinical investigations comparing selective versus non-selective NSAIDs as prophylaxis for HO following THA were accessed in February 2022. An assessment of the methodological quality and statistical analyses were performed through the risk of bias summary tool of the Review Manager 5.3 software (Cochrane Collaboration, Copenhagen). The modified Brooker staging system was used to rate the efficacies of the interventions.

RESULTS:

Data from 8 studies and 1526 patients were collected. 60.8% were female. No difference was found in the sample size, mean age, and percentage of females between the two groups at baseline. No statistically significant difference was found between selective and non-selective NSAIDs in term of efficacy. 72% (1078 of 1502) of the patients were classified as Brooker 0, 21% (322 of 1502) as Brooker I, 5% (80 of 1502) as Brooker II, 1% (16 of 1502) as Brooker III, and 0.1% (2 of 1502) as Brooker IV.

CONCLUSION:

Selective and non-selective NSAIDs were equally effective when used as prophylaxis for HO following THA.

LEVEL OF EVIDENCE:

Level III, systematic review and meta-analysis.

• Authors: Filippo Migliorini, Andrea Pintore, Alice Baroncini, Torsten Pastor, Frank Hildebrand, Nicola Maffulli
• Journal: Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology (J Orthop Traumatol) Vol. 23 Issue 1 Pg. 30 (Jul 09 2022) ISSN: 1590-9999 [Electronic] Italy
• PMID: 35809109 (Publication Type: Meta-Analysis, Systematic Review)
• Copyright: © 2022. The Author(s).

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal

Topics

• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Arthroplasty, Replacement, Hip (adverse effects)
• Female
• Humans
• Male
• Ossification, Heterotopic (etiology, prevention & control)
• Treatment Outcome