NZ Orthopaedic Association Scientific Meeting

MEDIA BACKGROUNDER

NZ Orthopaedic Association Annual Scientific Meeting

Auckland Sky City Convention Centre – October 15- 17 2007

Monday October 15, 1.00pm

Largest- ever clinical trial of anti-inflammatory drugs (NSAID) prophylaxis following hip replacement surgery
Presented by Garnet Tregonning, orthopaedic surgeon, Auckland

The largest ever trial of anti-inflammatory drug (NSAID) prophylaxis use for patients undergoing total hip replacement or revision surgery was conducted in 20 orthopaedic surgery centres in Australia and New Zealand between 2002 and 2004.

902 patients undergoing elective primary or revision total hip surgery took part in a double-blind randomised placebo-controlled clinical trial.

The purpose of the trial was to determine the benefit or risk of NSAID-based prophylaxis for ectopic bone formation.

Ectopic bone formation is abnormal bone that forms post-operatively in the soft tissues around the operated hip and occurs in 30-40% of patients having a primary hip replacement. It may cause pain and significant stiffness of the hip replacement and, in some cases, further surgery is required.

Patients were randomly allocated to 14 days’ treatment with ibuprofen (1200mg daily) or a matching placebo, which was commenced within 24 hours of surgery. Outcomes were assessed 6-12 months after surgery and included changes in self-reported hip pain and physical function, physical performance measures and radiographic evidence of ectopic bone formation.

Results showed that 6-12 months after surgery, there were no significant differences between the ibuprofen and placebo groups for improvements in hip pain, despite a significantly reduced risk of ectopic bone formation associated with ibuprofen. Accordingly, the study results do not support the use of routine NSAIDs-based prophylaxis for patients undergoing total hip replacement surgery.

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