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塞来昔布预防成人创伤后肘关节僵硬切开松解术后异位骨化复发的疗效。

The efficacy of celecoxib in preventing heterotopic ossification recurrence after open arthrolysis for post-traumatic elbow stiffness in adults.

作者信息

Sun Yangbai, Cai Jiangyu, Li Fengfeng, Liu Shen, Ruan Hongjiang, Fan Cunyi

机构信息

Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

出版信息

J Shoulder Elbow Surg. 2015 Nov;24(11):1735-40. doi: 10.1016/j.jse.2015.07.006.

Abstract

BACKGROUND

Heterotopic ossification (HO) recurrence after joint surgery is always a disturbing problem for patients and surgeons. Our study was performed to assess the efficacy and safety of celecoxib in preventing the recurrence of HO after open arthrolysis for post-traumatic elbow stiffness.

METHODS

We retrospectively studied 152 patients with stiff elbows caused by post-traumatic HO. After surgery, 77 patients received celecoxib (200 mg once daily) for 28 days, whereas 75 did not. Radiographic evaluation was performed at 3, 6, and 9 months postoperatively. Univariate and multivariate analyses were performed to determine which factors affected HO recurrence.

RESULTS

HO was both more common and more severe in the no-celecoxib group than in the celecoxib group at 3, 6, and 9 months after surgery. A significant difference was observed between the 2 groups in terms of postoperative extension (P = .030), flexion (P = .008), and pronation (P = .005); however, no significant difference in postoperative supination was noted (P = .622). Logistic regression analysis showed that taking celecoxib was the protective factor for HO recurrence, whereas overweight (body mass index > 25) and male gender were the risk factors.

CONCLUSIONS

A short course of celecoxib aids in the prevention of HO recurrence after open arthrolysis for elbow stiffness in adults and could be an effective and safe option.

摘要

背景

关节手术后异位骨化(HO)复发一直是困扰患者和外科医生的问题。我们开展这项研究旨在评估塞来昔布预防创伤后肘关节僵硬切开松解术后HO复发的有效性和安全性。

方法

我们回顾性研究了152例因创伤后HO导致肘关节僵硬的患者。术后,77例患者接受塞来昔布治疗(每日1次,每次200 mg),持续28天,而75例患者未接受该治疗。术后3、6和9个月进行影像学评估。进行单因素和多因素分析以确定哪些因素影响HO复发。

结果

术后3、6和9个月,未使用塞来昔布组的HO比使用塞来昔布组更常见且更严重。两组在术后伸展(P = 0.030)、屈曲(P = 0.008)和旋前(P = 0.005)方面存在显著差异;然而,术后旋后方面未观察到显著差异(P = 0.622)。逻辑回归分析表明,服用塞来昔布是HO复发的保护因素,而超重(体重指数>25)和男性是危险因素。

结论

短期使用塞来昔布有助于预防成人肘关节僵硬切开松解术后HO复发,可能是一种有效且安全的选择。

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