30786
document
Similar effects of rofecoxib and indomethacin on the incidence of heterotopic ossification after hip arthroplasty . BACKGROUND Although indomethacin is effective in preventing heterotopic ossification ( HO ) after primary total hip arthroplasty , side effects are frequently observed . In the last decade a new class of drugs -- the COX-2 selective nonsteroidal anti-inflammatory drugs -- has been developed . To investigate the effect of these COX-2 selective NSAIDs on heterotopic ossification ( HO ) after primary total hip arthroplasty ( THA ) , we conducted a randomized controlled trial using either indomethacin or rofecoxib for 7 days . METHODS 186 patients received either indomethacin 3 times daily , or rofecoxib twice , and 1 placebo , daily for 7 days . HO was graded according to the 1-year postoperative radiographs according to the Brooker classification . RESULTS 12 of the 186 patients included discontinued their medication before the end of the trial due to side effects . The remaining 174 patients were included in the analysis . In the indomethacin group ( n = 89 ) , 77 patients ( 87 % ) showed no HO , 9 showed HO of grade 1 and 3 showed HO of grade 2 according to the Brooker classification . In the rofecoxib group ( n = 85 ) 73 patients ( 86 % ) showed no ossification , 9 showed grade 1 , and 3 showed grade 2 . INTERPRETATION The prophylactic effect of rofecoxib for 7 days in preventing heterotopic ossification after primary total hip arthroplasty is comparable to the effect of indomethacin given for 7 days . These results indicate that the development of HO follows a COX-2 pathway .
30787
Intervention_Pharmacological
indomethacin
30788
Intervention_Pharmacological
COX-2 selective nonsteroidal anti-inflammatory drugs
30789
Intervention_Pharmacological
COX-2 selective NSAIDs
30790
Intervention_Pharmacological
indomethacin
30791
Intervention_Pharmacological
rofecoxib
30792
Intervention_Pharmacological
indomethacin
30793
Intervention_Pharmacological
rofecoxib
30794
Intervention_Control
placebo
30795
Intervention_Pharmacological
indomethacin
30796
Intervention_Pharmacological
rofecoxib
30797
Intervention_Pharmacological
rofecoxib
30798
Intervention_Pharmacological
indomethacin
30799
Outcome_Physical
heterotopic ossification
30800
Outcome_Adverse-effects
side effects
30801
Outcome_Other
NSAIDs
30802
Outcome_Physical
heterotopic ossification
30803
Outcome_Physical
HO
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Outcome_Other
discontinued
30805
Outcome_Adverse-effects
side effects
30806
Outcome_Physical
showed no HO
30807
Outcome_Physical
showed HO of grade 1
30808
Outcome_Physical
showed HO of grade 2
30809
Outcome_Physical
showed no ossification
30810
Outcome_Physical
showed grade 1
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Outcome_Physical
showed grade 2
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Participant_Condition
hip arthroplasty
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Participant_Condition
primary total hip arthroplasty
30814
Participant_Sample-size
186
30815
Participant_Sample-size
12
30816
Participant_Sample-size
174
30817
Participant_Sample-size
89
30818
Participant_Sample-size
85