Indomethacin versus Ketorolac for the prevention of heterotopic ossification in hip arthroscopy patients

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-07-29 DOI:10.1016/j.jor.2025.07.032

Christopher S. Frey , Thomas M. Spears , Daniel Puczko , Alicia M. Hymel , Candler G. Mathews , Patrick M. Luchini , Katherine D. Van Schaik , Jessica R. Leschied , Jaron Sullivan

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引用次数: 0

Abstract

Background

Nonsteroidal anti-inflammatory drugs are commonly utilized to reduce the risk of developing heterotopic ossification (HO) after hip arthroscopy. However, it is not known which regimen is optimal.

Purpose

The purpose of this study is to determine the rate of HO formation after hip arthroscopy in response to different NSAID protocols.

Methods

Consecutive cases of a single fellowship-trained surgeon at a tertiary referral center were retrospectively reviewed. Patients received a regimen of two medications, starting with four days of either Ketorolac or Indomethacin and ending with either Celecoxib, Meloxicam, Diclofenac, or Naproxen. Two reviewers assessed HO on postoperative radiographs.

Results

323 cases were included for retrospective review. 48 (15 %) were found to develop HO after hip arthroscopy. Patients who also underwent labral repair (p = 0.046) and those with larger corrections in alpha angle (p = 0.048) were found to have higher rates of HO. Multivariate regression found that receiving Meloxicam as a second medication was found to have a significantly higher risk of HO than Celecoxib (OR 4.72, p = 0.035). Male gender (OR 2.36, p = 0.013), was also found to be associated with a higher likelihood of HO formation according to the model.

Conclusion

While taking Meloxicam as the second NSAID was associated with a significantly higher rate of HO than Celecoxib, no one regimen was found to be superior. Additionally, male gender was found to be a significant predictor of HO development.

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吲哚美辛与酮罗拉酸预防髋关节镜患者异位骨化的比较

背景：非甾体类抗炎药通常用于降低髋关节镜术后异位骨化（HO）的风险。然而，目前尚不清楚哪种方案是最佳的。目的本研究的目的是确定不同非甾体抗炎药方案对髋关节镜术后HO形成率的影响。方法回顾性分析一位在三级转诊中心接受过奖学金培训的外科医生的连续病例。患者接受两种药物治疗方案，开始使用4天的酮咯酸或吲哚美辛，结束使用塞来昔布、美洛昔康、双氯芬酸或萘普生。两位审稿人评估了术后x线片上的HO。结果323例纳入回顾性分析。48例（15%）在髋关节镜检查后出现HO。同时进行唇瓣修复（p = 0.046）和α角矫正较大（p = 0.048）的患者HO发生率较高。多因素回归发现，接受美洛昔康作为第二种药物的患者发生HO的风险明显高于塞来昔布（OR 4.72, p = 0.035）。根据该模型，男性性别（OR 2.36, p = 0.013）也被发现与更高的HO形成可能性相关。结论美洛昔康作为第二种非甾体抗炎药的HO发生率明显高于塞来昔布，但没有哪一种方案更优。此外，男性性别被发现是HO发展的重要预测因子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.