RT Journal
A1 Abdul-Hadi, Omar
A1 Parvizi, Javad
A1 Austin, Matthew S.
A1 Viscusi, Eugene
A1 Einhorn, Thomas
T1 Nonsteroidal Anti-Inflammatory Drugs in Orthopaedics
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2009
FD August 1
VO 91
IS 8
SP 2020
OP 2027
DO 
UL http://dx.doi.org/
AB 
Nonsteroidal anti-inflammatory drugs are widely used and prescribed in the United States. Between 35 and 70 million prescriptions for nonsteroidal anti-inflammatory drugs are written in the United States each year, and numerous agents are now available over the counter1. In particular, the prescription of cyclooxygenase-2 (COX-2) inhibitors has become widespread since they were approved by the U.S. Food and Drug Administration in 1999, and in 2000 nearly 45 million prescriptions were written for celecoxib and rofecoxib2. More than 17 million Americans use various nonsteroidal anti-inflammatory drugs on a daily basis. Moreover, it has been estimated that 5% to 7% of all hospital admissions are related to adverse drug reactions, with nonsteroidal anti-inflammatory drugs being the culprit in 30% of these cases3. As a result of the aging of the population, there will be an increase in the use of nonsteroidal anti-inflammatory drugs parallel to the increase in the prevalence of painful degenerative musculoskeletal conditions. Despite the rising popularity of COX-2 inhibitors, their role in orthopaedic surgery remains controversial. Several studies have demonstrated the inhibitory effect of COX-2 inhibitors on bone-healing, and the inhibitory effect of traditional nonsteroidal anti-inflammatory drugs is already well known4. The use of COX-2 inhibitors is growing in the elderly population, and there are multiple concerns regarding the adverse side effects and the theoretical basis of safety of COX-2 inhibitors in orthopaedic patients.