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Is etoricoxib effective in preventing heterotopic ossification after primary total hip arthroplasty?

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Abstract

Purpose

Heterotopic ossification is a common complication after total hip arthroplasty. Non-steroidal anti-inflammatory drugs (NSAIDs) are known to prevent heterotopic ossifications effectively, however gastrointestinal complaints are reported frequently. In this study, we investigated whether etoricoxib, a selective cyclo-oxygenase-2 (COX-2) inhibitor that produces fewer gastrointestinal side effects, is an effective alternative for the prevention of heterotopic ossification.

Methods

We investigated the effectiveness of oral etoricoxib 90 mg for seven days in a prospective two-stage study design for phase-2 clinical trials in a small sample of patients (n = 42). A cemented primary total hip arthroplasty was implanted for osteoarthritis. Six months after surgery, heterotopic ossification was determined on anteroposterior pelvic radiographs using the Brooker classification.

Results

No heterotopic ossification was found in 62 % of the patients that took etoricoxib; 31 % of the patients had Brooker grade 1 and 7 % Brooker grade 2 ossification.

Conclusions

Etoricoxib seems effective in preventing heterotopic ossification after total hip arthroplasty. This finding further supports the use of COX-2 inhibitors for the prevention of heterotopic ossification following total hip arthroplasty.

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Funding

The study was supported in part by a research grant from the Investigator-Initiated Studies Program of Merck & Co., Inc. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck & Co., Inc.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedics, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands

    Jaap J. Brunnekreef, Paul Hoogervorst, Wim H. Rijnen & Berend W. Schreurs

  2. Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Marieke J. Ploegmakers

Authors
  1. Jaap J. Brunnekreef
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  2. Paul Hoogervorst
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  3. Marieke J. Ploegmakers
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  4. Wim H. Rijnen
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  5. Berend W. Schreurs
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Corresponding author

Correspondence to Berend W. Schreurs.

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Brunnekreef, J.J., Hoogervorst, P., Ploegmakers, M.J. et al. Is etoricoxib effective in preventing heterotopic ossification after primary total hip arthroplasty?. International Orthopaedics (SICOT) 37, 583–587 (2013). https://doi.org/10.1007/s00264-013-1781-0

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  • DOI: https://doi.org/10.1007/s00264-013-1781-0

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