title: Nonsteroidal anti-inflammatory drugs: are they safe after joint arthroplasty for early pain?
abstract: A significant proportion of patients will experience moderate to severe pain after hip or knee replacement surgery. Multimodal pain control regimens have been developed to address this issue. These regimens may include the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Concern over excessive bleeding in the perioperative period, especially in joint arthroplasty patients receiving anticoagulation therapy, generally prohibits the use of nonspecific NSAIDs. Cyclooxygenase-2 inhibitors, a class of NSAIDs, are not believed to increase the risk of bleeding and may be useful in this population of patients. However, recent research shows increased cardiovascular and renal risks with cyclooxygenase-2 inhibitors and has limited their use for postoperative pain control in joint arthroplasty patients.
authors.affiliation: Department of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Purtill
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D019643:Arthroplasty, Replacement; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D002318:Cardiovascular Diseases / Q000139:chemically induced; D002985:Clinical Protocols; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D010149:Postoperative Pain / Q000517:prevention & control*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors