01675nas a2200217   4500000000100000008004100001653001100042653001600053653000900069100001300078700001200091700001200103700001200115700001400127700001500141700001500156245016200171300001000333490000700343520110700350       2000                            d10aNSAIDS10ahip surgery10aBone1 aClark T.1 aReid I.1 aGray H.1 aDunn L.1 aRodgers A1 aNeal Bruce1 aMacmahon S00aA systematic survey of 13 randomized trials of non-steroidal anti-inflammatory drugs for the prevention of heterotopic bone formation after major hip surgery  a122-80 v713 a<p>
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. [References: 28]
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