title: 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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Orthopedics, Sana Arthritis Hospital, Bad Wildbad, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sell
authors.forename: Oliver
authors.initials: O
authors.lastname: Phillips
authors.forename: Martin
authors.initials: M
authors.lastname: Handel
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D004008:Diclofenac / Q000008:administration & dosage* / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000209:etiology / Q000517:prevention & control*; D012720:Severity of Illness Index
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac