The Pharmaceutical Journal
Vol 277 No 7419 p361
23 September 2006

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Routine NSAID treatment after hip replacement not justified

Patients who undergo hip replacement surgery should not routinely receive postoperative non-steroidal anti-inflammatory drugs as prophylaxis against ectopic bone formation, according to Australian researchers (BMJ 2006;333:519).

The researchers examined the safety and efficacy of ibuprofen in 902 patients undergoing total hip replacement surgery. Compared with placebo, ibuprofen was associated with a reduced rate of ectopic bone formation. But this reduction did not lead to better long-term clinical outcomes and ibuprofen was associated with an increased risk of bleeding.

“Recommendations promoting routine prophylaxis with a short course of postoperative NSAIDs for all patients undergoing hip arthroplasty are not justified. While some patients at high risk of ectopic bone formation (such as those with a history of it) may derive clinical benefits from prophylaxis with non-steroidal anti-inflammatory drugs that outweigh any risks, randomised trials are required to substantiate this,” the researchers write.