Cyclooxygenase-2 inhibitors and knee prosthesis surgery

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Cyclooxygenase-2 inhibitors

and knee prosthesis surgery

Linköping University Medical Dissertations, No. 1077

Andreas Meunier

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8 Thesis at a glance

Paper Question Material Study design and method Conclusions

I Does COX-2 inhibition impair metaphyseal bone healing?

70 rats Randomised controlled trial, parecoxib administered via implanted minipump, pull-out force of a screw in tibial metaphysis

Yes, but only transiently

II Does COX-2 inhibition affect clinical results after total knee replacement?

50 patients Randomised controlled trial, placebo vs celecoxib during 3 weeks,

blood loss, VAS pain, range of motion, KOOS

Early pain relief, no effects after 1 or 2 years III Does COX-2

inhibition affect fixation of total knee prosthesis?

50 patients Randomised controlled trial, placebo vs celecoxib during 3 weeks, radiostereometry No effects on prosthesis migration IV Is the Hb dilution

method valid for estimation of perioperative blood loss? 39 blood donors Observation study, measured blood loss vs estimated blood loss in blood donors Low accuracy, low precision, blood volume stabilized day 6 after donation

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