NSAIDs Inhibit Tendon-to-Bone Healing in Rotator Cuff Repair

Medical abstract

A two-week course of indomethacin or celecoxib significantly inhibits tendon-to-bone healing in rotator cuff repair for eight weeks, according to the results of a preliminary study presented at the annual meeting of the American Orthopaedic Society for Sports Medicine in Quebec City, Canada.

"Rotator cuff healing involves bone growing into the tendon (bone formation at that junction)...and failure rates of healing are pretty high," Scott A. Rodeo, MD, lead author of the study and orthopaedic surgeon and sports medicine specialist at the Hospital for Special Surgery at Cornell Medical Center in New York City, told Medscape.

"There's good data now demonstrating that nonsteroidal anti-inflammatory drugs (NSAIDs) can have adverse effects on bone healing...we hypothesized that they may have an adverse effect on rotator cuff repairs."

The study involved 180 rats that underwent acute rotator cuff repair surgery. For two weeks postsurgery, 60 rats were treated with indomethacin (a nonspecific NSAID), 60 with celecoxib (a cyclooxygenase 2 [COX-2] inhibitor NSAID), and the remaining 60 rats received standard rat chow. The animals were then sacrificed at two, four, and eight weeks.

While all tendons in the control group healed, four tendons in the celecoxib group and one tendon in the indomethacin group failed to heal. Biomechanical testing demonstrated significantly lower failure loads in the celecoxib and indomethacin groups compared with the control group at two, four, and eight weeks (P < .001) with no significant difference between the NSAID groups at any time.

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