Macfarlane Robert J, Ng Boon Han, Gamie Zakareya, El Masry Mohamed A, Velonis Stylianos, Schizas Constantin, Tsiridis Eleftherios
University of Leeds, Academic Department of Trauma and Orthopaedics, School of Medicine, Clarendon Wing A, Leeds General Infirmary Teaching Hospitals NHS Trust, Great George Street, Leeds LS1 3EX, UK
Expert Opin Pharmacother. 2008 Apr;9(5):767-86. doi: 10.1517/14656566.9.5.767.
Heterotopic ossification is a common complication following total hip arthroplasty and surgery following acetabular trauma. It is associated with pain and a decreased range of movement. Prophylaxis is achieved by either non-steroidal anti-inflammatory drug treatment or localised irradiation therapy. The objective of this study was to evaluate the evidence for pharmacological agents used for the prophylaxis of heterotopic ossification following hip and acetabular surgery. The study used a comprehensive literature search to identify all major clinical studies investigating the pharmacological agents used in the prophylaxis of heterotopic ossification following hip and acetabular surgery. It was concluded that indometacin remains the 'gold standard' for heterotopic ossification prophylaxis following total hip arthroplasty and is the only drug proven to be effective against heterotopic ossification following acetabular surgery. Following total hip arthroplasty, other non-steroidal anti-inflammatory drugs, including naproxen and diclofenac, are equally as effective as indometacin and can be considered as alternative first-line treatments. Celecoxib is also of equal efficacy to indometacin and is associated with significantly fewer gastrointestinal side effects. However, serious concerns were raised over the safety of selective cyclooxygenase-2 inhibitors for the cardiovascular system and these should be used cautiously.
异位骨化是全髋关节置换术和髋臼创伤手术后的常见并发症。它与疼痛和活动范围减小有关。预防可通过非甾体抗炎药治疗或局部放射治疗来实现。本研究的目的是评估用于预防髋部和髋臼手术后异位骨化的药物的证据。该研究通过全面的文献检索，以确定所有主要的临床研究，这些研究调查了用于预防髋部和髋臼手术后异位骨化的药物。得出的结论是，吲哚美辛仍然是全髋关节置换术后异位骨化预防的“金标准”，并且是唯一被证明对髋臼手术后异位骨化有效的药物。全髋关节置换术后，其他非甾体抗炎药，包括萘普生和双氯芬酸，与吲哚美辛同样有效，可被视为替代一线治疗药物。塞来昔布与吲哚美辛疗效相当，且胃肠道副作用明显较少。然而，人们对选择性环氧化酶-2抑制剂对心血管系统的安全性提出了严重担忧，应谨慎使用。
