Do anti inflammatory medications interfere with healing?
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Ibuprofen impairs capsulolabral healing in a rat model of anterior glenohumeral instability
These authors used a rat model to determine the effect of nonsteroidal antiinflammatory drugs (NSAIDs) on the healing glenoid labrum and capsule after glenohumeral dislocation.
Sixty-six rats had surgically induced anterior-inferior labral tears and anterior glenohumeral dislocation. Postoperatively, the animals were assigned to either normal (n = 32) or ibuprofen drinking water (n = 31). Animals were euthanized at 2 and 4 weeks postoperatively for biomechanical testing and histologic analysis.
They found that the postinjury administration of ibuprofen resulted in decreased capsulolabral healing as indicated by decreased stiffness and maximal load to failure.
and delayed histologic evidence of healing
These authors point to a clinical study investigating the effect of NSAIDs on capsulolabral healing in 477 patients from the Norwegian shoulder instability registry with a primary arthroscopic Bankart procedure (see this link). The Western Ontario Shoulder Instability Index and the reoperation rate of the patients who received NSAIDs postoperatively were not statistically significant from those who did not.
Comment: There are substantial data suggesting that non-steroidal anti-inflammatory medications can interfere with the progress of healing of soft tissue injuries and repairs, fractures and surgical fusions.
On the other hand, these medications are effective non-narcotic analgesics with great utility in the postoperative period. They may also be effective in combatting stiffness after arthroplasty.
In situations where healing is likely to be robust (e.g. in healing the subscapularis repair after a shoulder arthroplasty) we use immediate postoperative NSAIDs because the benefit seems to outweigh the resk.
However, where healing is uncertain, for example in rotator cuff repair, there may be a consideration to avoid these medications, although again the evidence comes primarily from animal models (see this link).
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The reader may also be interested in these posts:
Consultation for those who live a distance away from Seattle.
Click here to see the new Shoulder Arthritis Book.
Click here to see the new Rotator Cuff Book
Information about shoulder exercises can be found at this link.
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
See from which cities our patients come.
See the countries from which our readers come on this post.
These authors used a rat model to determine the effect of nonsteroidal antiinflammatory drugs (NSAIDs) on the healing glenoid labrum and capsule after glenohumeral dislocation.
Sixty-six rats had surgically induced anterior-inferior labral tears and anterior glenohumeral dislocation. Postoperatively, the animals were assigned to either normal (n = 32) or ibuprofen drinking water (n = 31). Animals were euthanized at 2 and 4 weeks postoperatively for biomechanical testing and histologic analysis.
They found that the postinjury administration of ibuprofen resulted in decreased capsulolabral healing as indicated by decreased stiffness and maximal load to failure.
and delayed histologic evidence of healing
These authors point to a clinical study investigating the effect of NSAIDs on capsulolabral healing in 477 patients from the Norwegian shoulder instability registry with a primary arthroscopic Bankart procedure (see this link). The Western Ontario Shoulder Instability Index and the reoperation rate of the patients who received NSAIDs postoperatively were not statistically significant from those who did not.
Comment: There are substantial data suggesting that non-steroidal anti-inflammatory medications can interfere with the progress of healing of soft tissue injuries and repairs, fractures and surgical fusions.
On the other hand, these medications are effective non-narcotic analgesics with great utility in the postoperative period. They may also be effective in combatting stiffness after arthroplasty.
In situations where healing is likely to be robust (e.g. in healing the subscapularis repair after a shoulder arthroplasty) we use immediate postoperative NSAIDs because the benefit seems to outweigh the resk.
However, where healing is uncertain, for example in rotator cuff repair, there may be a consideration to avoid these medications, although again the evidence comes primarily from animal models (see this link).
====
The reader may also be interested in these posts:
Consultation for those who live a distance away from Seattle.
Click here to see the new Shoulder Arthritis Book.
Click here to see the new Rotator Cuff Book
Information about shoulder exercises can be found at this link.
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
See from which cities our patients come.
See the countries from which our readers come on this post.
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