A Cyclooxygenase-2 Inhibitor Impairs Ligament Healing in the Rat

2001 ◽  
Vol 29 (6) ◽  
pp. 801-805 ◽  
Author(s):  
Christopher L. Elder ◽  
Laurence E. Dahners ◽  
Paul S. Weinhold
Keyword(s):  
Medial Collateral Ligament ◽  
Soft Tissues ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Cyclooxygenase 2 ◽  
Ligament Injuries ◽  
Collateral Ligament ◽  
Antiinflammatory Drugs ◽  
Increased Risk ◽  
Ligament Healing ◽  
Specific Inhibitors

Celecoxib was the first of a new class of nonsteroidal antiinflammatory drugs, the cyclooxygenase-2 (COX-2) specific inhibitors, marketed as having the same antiinflammatory efficacy as other nonsteroidal antiinflammatory drugs without their increased risk of gastrointestinal ulceration. Among the widest uses of nonsteroidal antiinflammatory drugs is in the treatment of acute soft tissue injuries. Although the benefits of celecoxib have been shown when used for rheumatoid arthritis and osteoarthritis, we are unaware of any studies concerning its effect on soft tissues. We used the surgically incised medial collateral ligament of male Sprague-Dawley rats as an experimental model for acute ligament injuries to investigate the effects of celecoxib on ligament healing. Fifty rats underwent surgical transection of the right medial collateral ligament. Postoperatively, half were given celecoxib for the first 6 days of recovery, the other half were not. The animals were sacrificed 14 days after the operation, and both the injured and uninjured medial collateral ligaments were mechanically tested to failure in tension. Celecoxib-treated/injured ligaments were found to have a 32% lower load to failure than untreated/ injured ligaments. The results of this study do not support use of cyclooxygenase-2 specific inhibitors in the treatment of ligament injuries.

The Effect of Analgesic Agents on the Healing Rat Medial Collateral Ligament

2005 ◽  
Vol 33 (5) ◽  
pp. 674-679 ◽  
Author(s):  
Curtis A. Hanson ◽  
Paul S. Weinhold ◽  
Hessam M. Afshari ◽  
Laurence E. Dahners
Keyword(s):  
Medial Collateral Ligament ◽  
Healing Process ◽  
Cyclooxygenase 2 ◽  
Ligament Injury ◽  
Sprague Dawley ◽  
Collateral Ligament ◽  
Inflammatory Drugs ◽  
Ligament Healing ◽  
Anti Inflammatory ◽  
Cyclooxygenase 2 Inhibitors

Background Studies have suggested that some nonselective nonsteroidal anti-inflammatory drugs, including piroxicam, may improve ligament healing, whereas other nonsteroidal anti-inflammatory drugs, including ibuprofen and the cyclooxygenase-2 inhibitor celecoxib, may have no effect on the mechanical properties or may even deter the healing process. These results might reflect variations in cyclooxygenase enzyme selectivity by different drugs or, alternatively, may be related to their analgesic properties because it is generally accepted that early activity improves ligament healing. Hypothesis Nonselective nonsteroidal anti-inflammatory drugs improve ligament healing, whereas other analgesics provide lesser degrees of improvement, and cyclooxygenase-2 inhibitors are detrimental. Study Design Controlled laboratory study. Methods One hundred fifty-five Sprague-Dawley rats were divided into 7 treatment groups (piroxicam, naproxen, rofecoxib, butorphanol, 2 doses of acetaminophen, and control). The right medial collateral ligament of each rat was transected, and the drugs were administered postoperatively on days 1 to 6. On day 14, the rats were sacrificed, and mechanical testing was performed on the medial collateral ligament. Results The piroxicam group demonstrated significantly greater load to failure (27%) compared with the control. No significant differences were observed between other groups. Conclusions Piroxicam improves ligament healing, but this effect cannot be attributed to all nonselective nonsteroidal anti-inflammatory drugs. Opiate analgesics, acetaminophen, and cyclooxygenase-2 inhibitors do not appear to categorically affect ligament healing. Clinical Relevance In the treatment of ligament injury, piroxicam may be a drug of choice.

Thumb Injuries and Instabilities. Part 2: Spectrum of Lesions

2021 ◽  
Vol 25 (02) ◽  
pp. 355-365
Author(s):  
Alain G. Blum ◽  
Marnix T. van Holsbeeck ◽  
Stefano Bianchi
Keyword(s):  
Soft Tissues ◽  
Imaging Techniques ◽  
Metacarpophalangeal Joint ◽  
Resonance Imaging ◽  
Ligament Injuries ◽  
First Line ◽  
Collateral Ligament ◽  
Traumatic Injuries ◽  
Line Imaging

AbstractThe motor function of the thumb and its alignment with regard to the hand make it particularly vulnerable to trauma. Pathology encountered in this joint is varied, and imaging techniques play a crucial role in the diagnosis and characterization of injury. Despite advances in imaging technology, acute thumb injuries remain a challenge for radiologists. Currently, standard radiography and ultrasonography are frequently used first-line imaging techniques. Computed tomography is most often indicated for complex fractures and dislocations. Magnetic resonance imaging may be used to optimally characterize soft tissues and bone marrow. In this article, we cover the most common traumatic injuries: fractures, dislocations, collateral ligament injuries of the metacarpophalangeal joint, as well as soft tissue lesions.

scholarly journals Factors Associated with Celecoxib and Rofecoxib Utilization

2005 ◽  
Vol 39 (4) ◽  
pp. 597-602 ◽  
Author(s):  
Nigel SB Rawson ◽  
Parivash Nourjah ◽  
Stella C Grosser ◽  
David J Graham
Keyword(s):  
Cardiovascular Disease ◽  
Disease Burden ◽  
Multiple Logistic Regression Analysis ◽  
Underlying Disease ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Nonselective Nsaid ◽  
Antiinflammatory Drugs ◽  
The Past ◽  
Increased Risk ◽  
Cox 2

BACKGROUND: The cyclooxygenase-2 (COX-2) selective nonsteroidal antiinflammatory drugs (NSAIDs) celecoxib and rofecoxib (before its removal) are marketed as having fewer gastrointestinal (GI)-related complications than nonselective NSAIDs. However, adverse reaction data suggest that the use of COX-2 selective NSAIDs is associated with clinically significant GI events. OBJECTIVE: To assess whether patients receiving celecoxib and rofecoxib have a greater underlying disease burden than patients prescribed nonselective NSAIDs. METHODS: The study population consisted of members of 11 health plans, aged >34 years, with a pharmacy claim for celecoxib or rofecoxib or a nonselective NSAID dispensed between February 1, 1999, and July 31, 2001, who had been continuously enrolled for >364 days before the dispensing date. Celecoxib and rofecoxib patients were randomly selected without replacement from a pool of eligible users in each of the 30 months. Nonselective NSAID users were randomly chosen without replacement within each month on a 2:1 ratio to cases; they could be chosen in more than one month. Univariate analyses comparing 9000 cases and 18 000 controls were performed, followed by a multiple logistic regression analysis conditioned on time. RESULTS: Increasing age, treatment by a rheumatologist or an orthopedic specialist, treatment with a high number of different medications in the past year, treatment with oral corticosteroids in the past year, and having had a previous GI bleed increased the likelihood of receiving celecoxib or rofecoxib, whereas treatment with a high number of nonselective NSAID prescriptions in the past year decreased it. Treatment with a high number of different medications was a predictor of increased prevalence of underlying diabetes mellitus and cardiovascular disease. CONCLUSIONS: Patients having a greater underlying disease burden were more likely to receive COX-2 selective NSAIDs than nonselective ones. Paradoxically, patients at higher risk for cardiovascular disease were channeled toward treatment with COX-2 selective NSAIDs, many of which may confer an increased risk of acute myocardial infarction and other adverse cardiovascular outcomes.

Knee Medial Collateral Ligament Injuries

2015 ◽  
pp. 127-134
Author(s):  
Luis Pedro Duarte Silva ◽  
C. Desai ◽  
N. Loureiro ◽  
H. Pereira ◽  
J. Espregueira-Mendes
Keyword(s):  
Medial Collateral Ligament ◽  
Ligament Injuries ◽  
Collateral Ligament
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