Effects of a cyclooxygenase-2 inhibitor (rofecoxib) on bone healing.
In the study reported here, we determined the effects on bone healing of rofecoxib, one of the selective cyclooxygenase-2 (Cox-2) inhibitors that has been used for postsurgical analgesia, and compared these effects with those of nonselective ibuprofen and placebo. Each of 66 male rats received a closed, nondisplaced femoral fracture and was fed rofecoxib, ibuprofen, or placebo for 4 weeks. Results of postsacrifice evaluation showed gross nonunions in 64.7% of rofecoxib rats (P < .0001), 17.6% of ibuprofen rats (P = .007), and 0% of placebo rats. Compared with ibuprofen, rofecoxib was significantly more likely to produce nonunions (P = .007). Mean callus width was 8.9 mm (SD, 1.3 mm) for rofecoxib (P = .03), 8.9 mm (SD, 1.2 mm) for ibuprofen (P = .03), and 8.0 mm (SD, 1.3 mm) for placebo. Mean healing maturity (Goldberg classification) was 1.6 (SD, 0.7) for rofecoxib (P < .0001), 1.7 (SD, 0.8) for ibuprofen (P = .0001), and 2.7 (SD, 0.6) for placebo. Mean fracture angulation was 30.8 degrees (SD, 16.7 degrees) for rofecoxib (P = .003), 14.3 degrees (SD, 14.4 degrees) for ibuprofen (NS), and 13.4 degrees (SD, 10.3 degrees) for placebo. Mean histologic healing was 5.75 for rofecoxib (P = .02), 6.35 for ibuprofen (P = .05), and 8.25 for placebo. Cox-2 inhibitors should be used with caution when bone healing is necessary. Further study is warranted to determine whether the adverse effects occur in humans.
Department of Orthopaedics, University of Illinois-Chicago Medical Center, Chicago, IL 60612, USA.
Susan M
SM
Leonelli
Benjamin A
BA
Goldberg
John
J
Safanda
Mahesh R
MR
Bagwe
Shrividya
S
Sethuratnam
Susan J
SJ
King
D018712:Analgesics, Non-Narcotic / Q000494:pharmacology*; D000818:Animals; D002146:Bony Callus / Q000473:pathology; D052246:Cyclooxygenase 2 Inhibitors / Q000494:pharmacology*; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D017102:Fracture Healing / Q000187:drug effects*; D007052:Ibuprofen / Q000494:pharmacology; D008297:Male; D010919:Placebos; D011859:Radiography; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar
D018712:Analgesics, Non-Narcotic; D052246:Cyclooxygenase 2 Inhibitors; D010919:Placebos; D007052:Ibuprofen