Short-term treatment with COX-2 inhibitors does not impair fracture healing.
BACKGROUND
The effects of cyclooxygenase (COX) inhibition on fracture healing are insufficiently documented, and the aim of this study was to evaluate the effects of nonspecific and specific COX-2 inhibition in the early phase of fracture healing.


METHODS
Thirty rats were randomized in three groups. A diaphyseal fracture was performed and stabilized by intramedullary nailing. In group A parecoxib in a dose of 1 mg/kg body weight/day was given prior to surgery and daily for seven days; in group B diclofenac 2 mg/kg body weight/day was given; and in group C the same amount of saline was given. Blood samples were harvested at 7 and 30 days postoperatively and analyzed for active medications. At 30 days the rats were sacrificed, and the fractures were examined for bone mineralization and tested mechanically.


RESULTS
The fractures healed by the production of callus. Plasma concentrations at seven days of medication revealed therapeutic levels of parecoxib, valdecoxib, and diclofenac. There were no significant differences in bone mineralization or mechanical characteristics between the three groups at 30 days postfracture.


CONCLUSIONS
This study indicates that nonspecific or specific COX-2 inhibitors in therapeutic doses during seven days after fracture do not significantly influence bone healing.
Utvåg
Stein Erik
SE
Department of Orthopaedics, Akershus University Hospital, University of Oslo, Oslo, Norway.
Fuskevåg
Ole Martin
OM
Shegarfi
Hamid
H
Reikerås
Olav
O
D000818:Animals; D015519:Bone Density / Q000187:drug effects; D052246:Cyclooxygenase 2 Inhibitors / Q000494:pharmacology*; D004008:Diclofenac / Q000494:pharmacology; D017102:Fracture Healing / Q000187:drug effects*; D007555:Isoxazoles / Q000494:pharmacology; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D013449:Sulfonamides / Q000494:pharmacology; D000096926:Benzenesulfonamides
D052246:Cyclooxygenase 2 Inhibitors; D004008:Diclofenac; D007555:Isoxazoles; D013449:Sulfonamides; C406224:valdecoxib; D000096926:Benzenesulfonamides; C409945:parecoxib