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SJBird55 -> Re: WAY overly complex (March 12, 2006 6:41:00 AM)
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Oh, go shoot down the studies I present and ignore that you said that the only studies on bone healing were done on rats. You did use that "only" word, which is always a red flag for me. LOL That was an inaccurate statment. I heard a bit of sarcasm in the written remark and yes, THAT remark did feel as an "off the cuff" remark.
There are not a lot of studies out there on the combination of ibuprofen and spinal fusions. Before you decide to slam what I presented, see if you can find anything better. And I didn't plan on sitting here for hours on end, but spent 45 minutes to an hour just to see what was out there because your off the cuff remark got me curious.
Just the idea that there were studies on heterotopic bone formation was interesting to me... IF ibuprofen CAN reduce heterotopic bone formation after an arthroplasty, then there may be some validity to ibuprofen reducing osteoblast activity... Which after finding the shoulder arthroplasty study, did make me waiver in my thoughts as to the power of ibuprofen reducing osteoblast activity.
Wags, on that first study, on whether NSAIDs cause endoprosthetic loosening... ummm, there were 3 randomized groups - group 1 had ibuprofen for 1 week postoperatively, group 2 for 2 weeks postoperatively and group 3 had no ibuprofen. They were looking at the number of revisions... of the 142 patients, only 13 had revisions. 12 of those that had revisions were in the ibuprofen group. The main reason for revision was aseptic loosening... I'm not really sure if ibuprofen IS the variable because then later they assessed 94 other patients that were still alive radiographically - 9 loose prostheses were found in those living and the loose ones were not just found in those treated with ibuprofen but equally distributed. Personally, I kind of think that the reason for revisions is just the plain and simple fact that the loosening occurs because of the materials used and the inability for those materials to withstand the stresses/forces put on them over time.
If you had a shoulder arthroplasty and had a heterotopic ossification, I think you would care. It wouldn't be a very favorable outcome. IF it were found that ibuprofen use in the initial couple of weeks were helpful in reducing HO, well, I think you'd probably pop a few.
So, back to my guy... I saved what seemed to be the most relevant article for last... He is in a very high risk category for non-union/ non-fusion - smoker and multiple level fusions. And, from reading the articles, I do have the question in my head as to whether over the counter ibuprofen taken by the patient independently happens to have an impact. Technically, I don't believe over the counter use was addressed in the studies, nor did I find a study that addressed use of ibuprofen at home.
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