Joo Han Oh1, Hyuk Jun Seo2, Ye-Hyun Lee3, Hye-Yeon Choi4, Ho Yun Joung5, Sae Hoon Kim6. 1. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 2. Department of Orthopaedic Surgery, Daegu Chamtntn Hospital, Daegu, Republic of Korea. 3. Department of Orthopaedic Surgery, National Police Hospital, Seoul, Republic of Korea. 4. Department of Orthopaedic Surgery, Seoul Medical Center, Seoul, Republic of Korea. 5. Department of Orthopaedic Surgery, Wonkwang University School of Medicine, Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea. 6. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Abstract
BACKGROUND:Selective cyclooxygenase (COX)-2 inhibitors are commonly used analgesics that provide similar analgesia as that of other analgesics but with fewer adverse effects. However, few prospective studies have performed comparative analyses in this regard. PURPOSE: To evaluate the efficacy of a selective COX-2 inhibitor in early postoperative pain control, satisfaction with pain management, and incidence of systemic adverse effects in patients undergoing arthroscopic rotator cuff repair. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: This study included 180 patients who underwent arthroscopic rotator cuff repair between September 2011 and August 2012. The patients were randomly assigned to receive celecoxib, ibuprofen, or tramadol (n = 60 each). Visual analog scale (VAS) scores for pain intensity and satisfaction with medication, incidence of adverse effects, and use of rescue medication were recorded and compared between the 3 groups at 3 days and 2 weeks after surgery. Magnetic resonance and ultrasonography images of 82 patients were retrospectively reviewed at least 24 months after surgery, along with the range of motion and pain VAS and functional scores. RESULTS: There were no significant differences among the 3 groups in terms of pain intensity, incidence of adverse effects, or dosage of rescue medication at 3 days or 2 weeks after surgery. Pain VAS and functional scores at the final follow-up were also comparable among the 3 groups. However, the retear rate in the celecoxib group (11/30 [37%]) was significantly higher than those in the ibuprofen (2/27 [7%]) and tramadol (1/25 [4%]) groups ( P = .009). CONCLUSION: Despite having similar postoperative analgesic effects as other nonsteroidal anti-inflammatory drugs and opioids, selective COX-2 inhibitors should not be used for postoperative analgesia because they might negatively affect tendon-to-bone healing after surgical repair. Registration: NCT02850211 ( ClinicalTrials.gov identifier).
RCT Entities:
BACKGROUND: Selective cyclooxygenase (COX)-2 inhibitors are commonly used analgesics that provide similar analgesia as that of other analgesics but with fewer adverse effects. However, few prospective studies have performed comparative analyses in this regard. PURPOSE: To evaluate the efficacy of a selective COX-2 inhibitor in early postoperative pain control, satisfaction with pain management, and incidence of systemic adverse effects in patients undergoing arthroscopic rotator cuff repair. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: This study included 180 patients who underwent arthroscopic rotator cuff repair between September 2011 and August 2012. The patients were randomly assigned to receive celecoxib, ibuprofen, or tramadol (n = 60 each). Visual analog scale (VAS) scores for pain intensity and satisfaction with medication, incidence of adverse effects, and use of rescue medication were recorded and compared between the 3 groups at 3 days and 2 weeks after surgery. Magnetic resonance and ultrasonography images of 82 patients were retrospectively reviewed at least 24 months after surgery, along with the range of motion and pain VAS and functional scores. RESULTS: There were no significant differences among the 3 groups in terms of pain intensity, incidence of adverse effects, or dosage of rescue medication at 3 days or 2 weeks after surgery. Pain VAS and functional scores at the final follow-up were also comparable among the 3 groups. However, the retear rate in the celecoxib group (11/30 [37%]) was significantly higher than those in the ibuprofen (2/27 [7%]) and tramadol (1/25 [4%]) groups ( P = .009). CONCLUSION: Despite having similar postoperative analgesic effects as other nonsteroidal anti-inflammatory drugs and opioids, selective COX-2 inhibitors should not be used for postoperative analgesia because they might negatively affect tendon-to-bone healing after surgical repair. Registration: NCT02850211 ( ClinicalTrials.gov identifier).
Authors: Benjamin R Freedman; Andreas Kuttler; Nicolau Beckmann; Sungmin Nam; Daniel Kent; Michael Schuleit; Farshad Ramazani; Nathalie Accart; Anna Rock; Jianyu Li; Markus Kurz; Andreas Fisch; Thomas Ullrich; Michael W Hast; Yann Tinguely; Eckhard Weber; David J Mooney Journal: Nat Biomed Eng Date: 2022-01-03 Impact factor: 29.234
Authors: Jacob Gorbaty; Susan M Odum; Meghan K Wally; Rachel B Seymour; Nady Hamid; Joseph R Hsu; Michael Beuhler; Michael J Bosse; Michael Gibbs; Christopher Griggs; Steven Jarrett; Daniel Leas; Tamar Roomian; Michael Runyon; Animita Saha; Bradley Watling; Stephen Wyatt; Ziqing Yu Journal: Arthrosc Sports Med Rehabil Date: 2021-02-03