The prophylactic effect of Non-Steroidal Anti-inflammatory Drugs on Heterotopic Ossification after Total Hip Arthroplasty.
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[S.l. : s.n.]
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RU Radboud Universiteit Nijmegen, 6 oktober 2008
Promotor : Kampen, A. van Co-promotores : Schreurs, B.W., Rijnberg, W.J.
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SubjectEBP 2: Effective Hospital Care; NCEBP 10: Human Movement & Fatigue
Heterotopic ossification (HO) is formation of bone where it normally is not present. The incidence of HO after THA among different studies varies between 10 and 90%. Larger studies using the same or similar grading systems show considerably smaller variations, with HO ranging between 35 and 60%. Two different forms of prophylaxis of HO are being applied. The first is radiation therapy, which can be applied directly before or directly after the operation with similar results. The second mode of prophylaxis is by non-steroidal anti-inflammatory drugs (NSAIDs). Although indomethacin and several other NSAIDs are effective in preventing heterotopic ossification (HO) after primary total hip arthroplasty, side effects are frequently observed. Approximately 30% of all patients on traditional NSAIDs suffer from gastrointestinal side effects. In this thesis the next research questions were formulated: 1 Can the duration of treatment with indomethacin to prevent HO after THA be shortened? 2 Are the prophylactic effects of COX-2 selective NSAIDs on the development of HO after THA similar to that of indomethacin? 3 Do Non-Steroidal Anti-Inflammatory Drugs impair bone ingrowth? 4 Is it possible to measure the local inflammatory response after THA by means of cytokine levels at the site of surgery?
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