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Ten-year risk of failure in patients treated with ibuprofen at total hip arthroplasty
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
Manuscript (Other academic)
URN: urn:nbn:se:uu:diva-91210OAI: oai:DiVA.org:uu-91210DiVA: diva2:163864
Available from: 2003-12-23 Created: 2003-12-23 Last updated: 2010-01-13Bibliographically approved
In thesis
1. Heterotopic Ossification: Clinical and Experimental Studies on Risk Factors, Etiology and Inhibition by Non-steroidal Anti-inflammatory Drugs
Open this publication in new window or tab >>Heterotopic Ossification: Clinical and Experimental Studies on Risk Factors, Etiology and Inhibition by Non-steroidal Anti-inflammatory Drugs
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In this thesis, occurrence of heterotopic ossification (HO) following total hip arthroplasty (THA) was studied. Preventive effects and complications with non-steroidal anti-inflammatory drugs (NSAIDs) were analyzed. Experimental investigations on bone formation were employed to gain insight to the mechanism of NSAIDs action on bone.

(I). Fifty-six patients with bilateral THAs were analyzed. We found a strong correlation between HO on the two sides. Incidence and grade of HO were higher in men than in women.

(II). Sixty-nine patients with bilateral THAs who had been treated with NSAIDs after one or both THAs were analyzed for HO. Widespread HO occurred in untreated THAs, but in none of the treated THAs.

(III). A consecutive series of THAs were analyzed for HO. No widespread HO occurred in patients treated with NSAIDs for 21 days. In contrast, widespread HO occurred in 23% of patients not treated.

(IV). A randomized, double-blind, prospective study on 144 patients was performed to determine the efficacy and minimum treatment time with Ibuprofen for prophylaxis of HO after THA. Treatment with Ibuprofen was effective for preventing HO and a treatment time of 8 days was sufficient.

(V). A ten-year follow-up examination was performed on the patients from study IV. Thirteen patients had been revised. All but one belonged to groups treated with Ibuprofen. However, the prosthetic survival time was not statistically different for patients treated with NSAIDs compared to the control group. Eighty-four more patients underwent radiographic examination10 years after THA. Nine loose prostheses were found. These were equally distributed between NSAIDs-treated and non-treated THAs. When combining complications (revisions and radiographic loosening) no significant effects could be verified.

(VI). Experimental induction of heterotopic new bone with demineralized allogeneic bone matrix (DABM) and with bone autografts, was used in rats to study effects of NSAIDs on new bone formation. Indomethacin inhibited net bone formation in DABMs and in orthotopic fractured bone. In contrast, a net mineral loss occurred in autografts, but neither mineral content nor 45Ca incorporation was affected by Indomethacin treatment. The amount of bone formed per mg implanted DABM was linearly correlated to implant size.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2004. 47 p.
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1316
Surgery, Heterotopic ossification, Hip prosthesis, NSAIDs, Prophylaxis, Prosthesis loosening, Reoperation, Animal model, Bone formation, Kirurgi
National Category
urn:nbn:se:uu:diva-3908 (URN)91-554-5840-8 (ISBN)
Public defence
2004-01-30, Sal Hanö, Centralsjukhuset, JA Hedlunds v 5, Kristianstad, 13:15
Available from: 2003-12-23 Created: 2003-12-23Bibliographically approved

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