Acta orthopaedica
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Randomized Controlled Trial Comparative Study
Similar effects of rofecoxib and indomethacin on the incidence of heterotopic ossification after hip arthroplasty.
Although indomethacin is effective in preventing heterotopic ossification (HO) after primary total hip arthroplasty, side effects are frequently observed. In the last decade a new class of drugs--the COX-2 selective nonsteroidal anti-inflammatory drugs--has been developed. To investigate the effect of these COX-2 selective NSAIDs on heterotopic ossification (HO) after primary total hip arthroplasty (THA), we conducted a randomized controlled trial using either indomethacin or rofecoxib for 7 days. ⋯ The prophylactic effect of rofecoxib for 7 days in preventing heterotopic ossification after primary total hip arthroplasty is comparable to the effect of indomethacin given for 7 days. These results indicate that the development of HO follows a COX-2 pathway.
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Randomized Controlled Trial Comparative Study
Selective COX-2 inhibitor versus indomethacin for the prevention of heterotopic ossification after hip replacement: a double-blind randomized trial of 100 patients with 1-year follow-up.
Recent reports have suggested that selective COX-2 inhibition may be sufficient for the prevention of heterotopic ossification. ⋯ After short-term administration, the selective COX-2 inhibitor rofecoxib was effective in preventing heterotopic ossification after total hip arthroplasty.
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Treatment options in radial head fractures of Mason types III and IV range from open reduction and internal fixation (ORIF) to radial head resection with or without prosthetic replacement. ⋯ Reconstruction of comminuted radial head fractures can be performed with this device and radial head resection can be avoided.
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If it would be possible to detect lack of flow and/or the development of ischemia in bone, we might have a way of predicting whether a broken bone will heal. We established microdialysis (MD) and laser Doppler (LD) flow measurement in the human femoral head in order to be able to detect ischemia and measure changes in blood flow. ⋯ The use of MD was established in the human femoral head. Ischemic levels were detected within 2 h of cessation of blood flow in most patients.