Purpose
To evaluate the effectiveness of celecoxib, a selective cyclooxygenase 2 inhibitor,
in reducing heterotopic ossification (HO) after hip arthroscopic surgery and to evaluate
celecoxib’s impact on clinical outcomes.
Methods
We performed a retrospective review of patients who received hip arthroscopy performed
by the same surgeon between January 1, 2012, and December 31, 2016. Patients who had
an allergy to sulfa drugs, had pre-existing HO or previous surgery on the operative
side, or failed to complete radiographic follow-up at 6 months postoperatively were
excluded. Patients in the treatment group received 400 mg of celecoxib postoperatively
for 6 weeks, whereas the control group received no postoperative celecoxib. The incidence
of HO was assessed using anteroposterior radiographs obtained at 6 months, 1 year,
and 2 years postoperatively. Patients completed the International Hip Outcome Tool
33 survey, and the proportion of patients who met the minimal clinically important
difference, substantial clinical benefit (SCB), and absolute SCB was calculated.
Results
A total of 559 patients were identified. After application of the exclusion criteria,
454 patients were included in the study (211 in control group and 243 in treatment
group). The overall incidence of HO was 20.3% (n = 92). The treatment group had a
significantly lower incidence of HO at 6 months (P = .006), 1 year (P < .001), and 2 years (P = .008) postoperatively. At 2 years postoperatively, the treatment group had a significantly
higher International Hip Outcome Tool 33 score on average: 64.2 versus 57.3 (P = .023). No significant difference in the proportion of patients reaching the minimal
clinically important difference, SCB, or absolute SCB was found at any of the postoperative
time points.
Conclusion
The findings of this study suggest that a prophylactic treatment regimen of 400 mg
of celecoxib once daily for 6 weeks significantly reduces the incidence of HO formation
after hip arthroscopic surgery; however, it did not impact clinical outcomes.
Level of Evidence
Level III, retrospective, comparative case-control study.
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Article Info
Publication History
Published online: November 13, 2019
Accepted:
August 15,
2019
Received:
August 29,
2018
Footnotes
See commentary on page 462
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
