title: NSAID therapy effects on healing of bone, tendon, and the enthesis.
abstract: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for the treatment of skeletal injuries. The ability of NSAIDs to reduce pain and inflammation is well-established. However, the effects of NSAID therapy on healing of skeletal injuries is less defined. NSAIDs inhibit cyclooxygenase activity to reduce synthesis of prostaglandins, which are proinflammatory, lipid-signaling molecules. Inhibition of cyclooxygenase activity can impact many physiological processes. The effects of NSAID therapy on healing of bone, tendon, and the tendon-to-bone junction (enthesis) have been studied in animal and cell culture models, but human studies are few. Use of different NSAIDs with different pharmacological properties, differences in dosing regimens, and differences in study models and outcome measures have complicated comparisons between studies. In this review, we summarize the mechanisms by which bone, tendon, and enthesis healing occurs, and describe the effects of NSAID therapy on each of these processes. Determining the impact of NSAID therapy on healing of skeletal tissues will enable clinicians to appropriately manage the patient's condition and improve healing outcomes.
authors.affiliation: Rutgers, the State University of New Jersey, New Jersey Medical School, Department of Biochemistry and Molecular Biology, Newark, New Jersey.
authors.forename: Bailey
authors.initials: B
authors.lastname: Su
authors.forename: J Patrick
authors.initials: JP
authors.lastname: O'Connor
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D016718:Arachidonic Acid / Q000378:metabolism; D001842:Bone and Bones / Q000187:drug effects* / Q000293:injuries* / Q000503:physiopathology; D003238:Connective Tissue / Q000187:drug effects / Q000293:injuries / Q000503:physiopathology; D006801:Humans; D008022:Ligaments / Q000187:drug effects / Q000293:injuries / Q000503:physiopathology; D015398:Signal Transduction / Q000187:drug effects; D013708:Tendon Injuries / Q000188:drug therapy* / Q000503:physiopathology; D014945:Wound Healing / Q000187:drug effects / Q000502:physiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016718:Arachidonic Acid
keywords: cyclooxygenase; fracture healing; nonsteroidal anti-inflammatory drugs; tendon healing; tissue repair