Safety and efficacy of routine postoperative ibuprofen for pain and disability related to ectopic bone formation after hip replacement surgery (HIPAID): randomised controlled trial

Fransen, Marlene, Anderson, Craig, Douglas, Jan, MacMahon, Stephen, Neal, Bruce, Norton, Robyn, Woodward, Mark, Cameron, Ian D., Crawford, Ross W., Lo, Sing Kai, Tregonning, Garnet, & Windolf, Margaret (2006) Safety and efficacy of routine postoperative ibuprofen for pain and disability related to ectopic bone formation after hip replacement surgery (HIPAID): randomised controlled trial. BMJ, 333(7567), pp. 1-5.

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Objectives To determine the benefits and risks of a non-steroidal anti-inflammatory drug (NSAID) as prophylaxis for ectopic bone formation in patients undergoing total hip replacement (or revision) surgery.

Design Double blind randomised placebo controlled clinical trial, stratified by treatment site and surgery (primary or revision).

Setting 20 orthopaedic surgery centres in Australia and New Zealand.

Participants 902 patients undergoing elective primary or revision total hip replacement surgery.

Intervention 14 days' treatment with ibuprofen (1200 mg daily) or matching placebo started within 24 hours of surgery.

Main outcome measures Changes in self reported hip pain and physical function 6 to 12 months after surgery (Western Ontario and McMaster University Arthritis index).

Results There were no significant differences between the groups for improvements in hip pain (mean difference -0.1, 95% confidence interval -0.4 to 0.2, P = 0.6) or physical function (-0.1, -0.4 to 0.2, P = 0.5), despite a decreased risk of ectopic bone formation (relative risk 0.69, 0.56 to 0.83) associated with ibuprofen. There was a significantly increased risk of major bleeding complications in the ibuprofen group during the admission period (2.09, 1.00 to 4.39).

Conclusions These data do not support the use of routine prophylaxis with NSAIDs in patients undergoing total hip replacement surgery.

Impact and interest:

46 citations in Scopus
31 citations in Web of Science®
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ID Code: 10403
Item Type: Journal Article
Refereed: Yes
DOI: 10.1136/bmj.38925.471146.4F
ISSN: 0959-8138
Divisions: Past > QUT Faculties & Divisions > Faculty of Built Environment and Engineering
Copyright Owner: Copyright 2006 BMJ Publishing Group
Copyright Statement: Reproduced in accordance with the copyright policy of the publisher.
Deposited On: 24 Oct 2007 00:00
Last Modified: 29 Feb 2012 13:18

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