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Some Pain Medicines May Inhibit Healing

Tendon-to-bone healing may be jeopardized

CHICAGO, I.L.-- March 22, 2006 -- Certain anti-inflammatory medications slow tendon healing when taken immediately following surgery in an animal model, according to new research released today at the 2006 Annual Meeting of the American Academy of Orthopaedic Surgeons.

"Rats treated immediately following surgical repair with COX-2 inhibitors, including Celecoxib (Celebrex) and Valdecoxib (Bextra), had weaker tendons and a higher percentage of tendons that did not heal compared to the control group," says lead author Scott T. Ferry, MD, resident physician at the University of North Carolina Chapel Hill. "With the nonselective COX inhibitors, such as naproxen (Aleve) and piroxicam (Feldene), the tendons were slightly weaker, but not merely nearly as marked as with the COX-2 inhibitor-treated group."

Previous studies have demonstrated that some pain relievers are detrimental to bone healing when given immediately after injury or surgery. Dr. Ferry and his colleagues tested the same principle for tendons healing to the bone.

Dr. Ferry and colleagues evaluated patellar tendon strength and healing following tendon rupture and repair in 164 rats to determine the effect of commonly prescribed analgesics on the tendon healing. After surgery, the rats were divided into six treatment groups receiving celecoxib, naproxen, piroxicam, acetaminophen, ibuprofen, or valdecoxib. The seventh group received no medication.

The researchers found that COX-2 inhibitors appeared to interfere with patellar tendon healing. This was demonstrated by the following incidence of tendon repair suture failures: control (0/23), acetaminophen (0/24), celecoxib (6/22), ibuprofen (0/23), naproxen (3/24), piroxicam (4/24) and valdecoxib (10/24). To a lesser degree, similar changes were seen with the nonselective COX inhibitors piroxicam and naproxen. Ibuprofen and acetaminophen did not appear to inhibit healing strength.

The researchers concluded that both selective and nonselective COX inhibitors should be used judiciously in the early period for injuries where tendons attach to bones.

Dr. Ferry will present this information during a joint session of the American Orthopaedic Society for Sports Medicine and the American Shoulder and Elbow Surgeons at the American Academy of Orthopaedic Surgeons Annual Meeting on March 25, 2006, at 8 am CT in room E 354B at McCormick Place Convention Center in Chicago.


SOURCE: American Orthopaedic Society for Sports Medicine

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