Intended for healthcare professionals


Non-steroidal anti-inflammatory drugs after hip replacement

BMJ 2006; 333 doi: (Published 07 September 2006) Cite this as: BMJ 2006;333:507
  1. Fraser Birrell, consultant and senior lecturer in rheumatology (,
  2. Stefan Lohmander, senior lecturer
  1. Northumbria Healthcare NHS Trust and School of Clinical Medical Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH
  2. Department of Orthopaedics, University Hospital in Lund, SE-22185 Lund, Sweden

    Inhibit ectopic bone growth but do not reduce pain or disability

    The risks of cardiovascular and cerebrovascular toxicity associated with non-steroidal antiinflammatory drugs (NSAIDs)12 have prompted reappraisal of the use of these drugs and led to the inclusion of “black box” warnings in related prescribing information in the United States.3 The European Medicines Agency may also extend its warnings, given that the Medicines and Healthcare Products Regulatory Agency is considering unpublished data from a new clinical trial4 along with all other evidence and is seeking expert advice this month from the Commission on Human Medicines (MHRA, personal communication, 2006).

    Clinicians now avoid the use of NSAIDs in patients with established atheromatous disease. In this week's BMJ, however, Fransen and colleagues remind us that this class of drugs has many potential uses including inhibition of ectopic bone formation after joint replacement and postoperative pain relief.5 The authors report a randomised placebo controlled trial of a modest two week dose of postoperative ibuprofen (1200 mg a day) on …

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