The role of cyclooxygenase-2 inhibition in foot and ankle arthrodesis.
Cyclooxygenase-2 (COX-2) inhibitors are an important adjunct in controlling postoperative pain. Concerns exist regarding the use of NSAIDs for postoperative pain management because of the possible deleterious impact on bone healing in patients undergoing hindfoot arthrodesis. Orthopedic surgeons are concerned with: (1) a multimodal approach for postoperative pain control, and (2) bone healing following arthrodesis, fracture repair with rigid internal fixation, and cementless implants. The use of COX-2 inhibitors has been shown to be an important component of a pain control strategy but questions about their effects on bone healing have inhibited their use. This article discusses the laboratory and clinical data available on the use of COX-2 inhibitors on bone healing and their effects on foot and ankle arthrodesis procedures.
Hill
Keith
K
Orthopedic Foot and Ankle Center, Inc., 6200 Cleveland Ave, Suite 100, Columbus, OH 43231, USA.
Berlet
Gregory C
GC
Philbin
Terrence M
TM
Lee
Thomas H
TH
D000818:Animals; D000843:Ankle Joint / Q000601:surgery*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001174:Arthrodesis; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D005260:Female; D005528:Foot / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D014945:Wound Healing / Q000187:drug effects
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors