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We performed a systematic survey of randomized trials to determine the effects of perioperative NSAIDs on the occurrence of heterotopic bone formation, gastrointestinal side-effects and long-term clinical outcomes after major hip surgery. 13 trials involving 4,129 individuals were identified. Overall, in 12 small trials of medium-to-high-dose regimens, there was a 57% reduction (95% confidence interval 51%-63%) in the risk of heterotopic bone formation. The results of one large trial of low-dose aspirin differed markedly (2% reduction (95% CI 12% reduction to 15% increase)). The NSAID regimens studied had no definite effect on gastrointestinal complications, and data about the effects of NSAIDs on pain and function were too few, and too incompletely reported, to draw conclusions about their effects on these outcomes. Routine prophylaxis against heterotopic bone formation with NSAIDs may be a useful adjuvant therapy for patients undergoing major hip surgery, but the overall balance of risks and benefits requires assessment in a large-scale randomized trial.

Original publication

DOI

10.1080/000164700317413076

Type

Journal article

Journal

Acta Orthop Scand

Publication Date

04/2000

Volume

71

Pages

122 - 128

Keywords

Anti-Inflammatory Agents, Non-Steroidal, Arthroplasty, Replacement, Hip, Chemotherapy, Adjuvant, Gastrointestinal Diseases, Humans, Incidence, Ossification, Heterotopic, Pain, Postoperative, Randomized Controlled Trials as Topic, Regression Analysis, Research Design, Risk Factors, Treatment Outcome