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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 9, 1253-1260.
doi: 10.1302/0301-620X.89B9.19050  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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The effects of the short-term administration of low therapeutic doses of anti-COX-2 agents on the healing of fractures

AN EXPERIMENTAL STUDY IN RABBITS

T. Karachalios, MD, DSc, Associate Professor1; L. Boursinos, MD, Resident1; L. Poultsides, MD, Resident1; L. Khaldi, MD, Consultant Pathologist2; and K. N. Malizos, MD, DSc, Professor and Chairman1

1 Orthopaedic Department
2 Department of Pathology, School of Medicine, Faculty of Health Sciences, University of Thessaly, 22 Papakyriazi Street, Larisa 41222, Greece.

Correspondence should be sent to Dr T. Karachalios; e-mail: kar{at}med.uth.gr

We have evaluated the effect of the short-term administration of low therapeutic doses of modern COX-2 inhibitors on the healing of fractures.

A total of 40 adult male New Zealand rabbits were divided into five groups. A mid-diaphyseal osteotomy of the right ulna was performed and either normal saline, prednisolone, indometacin, meloxicam or rofecoxib was administered for five days. Radiological, biomechanical and histomorphometric evaluation was performed at six weeks.

In the group in which the highly selective anti-COX-2 agent, rofecoxib, was used the incidence of radiologically-incomplete union was similar to that in the control group. All the biomechanical parameters were statistically significantly lower in both the prednisolone and indometacin (p = 0.01) and in the meloxicam (p = 0.04) groups compared with the control group. Only the fracture load values were found to be statistically significantly lower (p = 0.05) in the rofecoxib group. Histomorphometric parameters were adversely affected in all groups with the specimens of the rofecoxib group showing the least negative effect.

Our findings indicated that the short-term administration of low therapeutic doses of a highly selective COX-2 inhibitor had a minor negative effect on bone healing.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General