van der Heide Huub J L, Hannink Gerjon, Buma Pieter, Schreurs B Willem
Department of Orthopedics, Orthopedic Research Laboratory, Nijmegen Medical Center, Radboud University, Nijmegen, the Netherlands.
Acta Orthop. 2008 Aug;79(4):548-54. doi: 10.1080/17453670710015562.
There is increasing awareness that non-steroidal anti-inflammatory drugs (NSAIDs), and especially the cyclooxygenase-2 (COX-2) selective ones, may retard bone healing. We have used NSAIDs (indomethacin for at least 7 days) to prevent heterotopic ossification after acetabular reconstructions using impacted bone grafts. The long-term clinical results have been satisfying, making it difficult to believe that there is an important negative effect of NSAIDs on graft incorporation. We studied the effect of two different NSAIDs on bone and tissue ingrowth in a bone chamber model in goats, using autograft, rinsed allograft, and allograft that had been rinsed and subsequently irradiated.
9 goats received no NSAIDs, 9 received ketoprofen, and 9 received meloxicam--all for 6 weeks. In each goat 6 bone chambers were implanted: 2 filled with autograft, 2 with rinsed allograft, and 2 with allograft that had been rinsed and irradiated. The amount of bone ingrowth and total tissue ingrowth was compared between the groups.
There were no statistically significant differences in bone ingrowth between the different groups. Also, no differences in bone ingrowth were found with respect to the type of graft used. Furthermore, there was no statistically significant difference in the total amount of ingrowth of fibrous tissue between the treatment groups.
No differences in bone ingrowth in titanium bone chambers could be detected with both ketoprofen and meloxicam compared to untreated control animals. This confirms our hypothesis that the effect of NSAIDs on the incorporation and ingrowth of bone graft is limited.
人们越来越意识到非甾体抗炎药（NSAIDs），尤其是环氧化酶-2（COX-2）选择性抑制剂，可能会延缓骨愈合。我们使用NSAIDs（吲哚美辛至少7天）来预防髋臼重建术中使用嵌压植骨后异位骨化的发生。长期临床结果令人满意，这让人难以相信NSAIDs对植骨融合有重要的负面影响。我们在山羊的骨腔模型中，使用自体骨移植、冲洗后的同种异体骨移植以及冲洗后再经照射的同种异体骨移植，研究了两种不同NSAIDs对骨和组织长入的影响。
9只山羊未接受NSAIDs治疗，9只接受酮洛芬治疗，9只接受美洛昔康治疗——均持续6周。每只山羊植入6个骨腔：2个填充自体骨移植，2个填充冲洗后的同种异体骨移植，2个填充冲洗后再经照射的同种异体骨移植。比较各组之间的骨长入量和总组织长入量。
不同组之间的骨长入量无统计学显著差异。同样，在使用的移植骨类型方面，骨长入也未发现差异。此外，治疗组之间纤维组织长入总量也无统计学显著差异。
与未治疗的对照动物相比，酮洛芬和美洛昔康在钛质骨腔中的骨长入方面均未检测到差异。这证实了我们的假设，即NSAIDs对骨移植融合和长入的影响是有限的。
