Randomised controlled clinical trial for the use of deracoxib during intense rehabilitation exercises after tibial plateau levelling osteotomy

W. J. Gordon-Evans; D. Dunning; A. L. Johnson; K. E. Knap

doi:10.3415/VCOT-09-11-0121

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2010; 23(05): 332-335
DOI: 10.3415/VCOT-09-11-0121

Original Research

Schattauer GmbH

Randomised controlled clinical trial for the use of deracoxib during intense rehabilitation exercises after tibial plateau levelling osteotomy

W. J. Gordon-Evans

¹University of Illinois, Department of Veterinary Clinical Medicine, Urbana, Illinois, USA

,

D. Dunning

²North Carolina State University, Department of Clinical Sciences, Raleigh, North Carolina, USA

,

A. L. Johnson

¹University of Illinois, Department of Veterinary Clinical Medicine, Urbana, Illinois, USA

,

K. E. Knap

¹University of Illinois, Department of Veterinary Clinical Medicine, Urbana, Illinois, USA

› Author Affiliations

Abstract

Summary

During intense physical exercise, the cyclooxygenase-2 (COX-2) pathway is upregulated which contributes to soreness. The aim of this study was to determine if there was a clinical affect of deracoxib (COX-2 selective antagonist) on dogs engaged in intense rehabilitation following tibial plateau levelling osteotomy for cranial cruciate ligament rupture. Our hypothesis was that dogs receiving deracoxib would demonstrate less lameness, better range-of-motion (ROM), and faster muscle mass recovery than the control dogs. Thirty dogs were randomised to the treatment (deracoxib at 1–2 mg/kg once daily by mouth) or control (no treatment) group. Outcomes including gait analysis, thigh circumference, and goniometry, were measured by one investigator, who was masked to group preoperatively, and at the end of each intense rehabilitation week (3, 5, and 7 weeks postoperatively). The only difference between groups for any outcome measure at any time point was a greater preoperative stifle ROM in the group receiving deracoxib (p = 0.04). This study showed that treatment with deracoxib did not provide better outcomes when dogs were subjected to intense rehabilitation after tibial plateau levelling osteotomy. Each patient should be evaluated individually to determine if administration of deracoxib is appropriate.

Keywords

NSAID - non-steroidal anti-inflammatory drugs - rehabilitation - exercise - TPLO - tibial plateau levelling osteotomy

Full Text

References

References
1 Rao P, Knaus EE. Evolution of nonsteroidal anti-inflammatory drugs (NSAIDs):cyclooxygenase (COX) inhibition and beyond. J Pharm Pharm Sci 2008; 11: 81s-110s
2 Paulsen G, Egner IM, Drange M. et al. A COX-2 inhibitor reduces muscle soreness, but does not influence recovery and adaptation after eccentric exercise. Scand J Med Sci Sports 2010; 20: e195-207.
3 Paulsen G, Lauritzen F, Bayer ML. et al. Subcellular movement and expression of HSP27, alphaB-crystallin, and HSP70 after two bouts of eccentric exercise in humans. J Appl Physiol 2009; 107: 570-582.
4 Peterson JM, Trappe TA, Mylona E. et al. Ibuprofen and acetaminophen: Effect on muscle inflammation after eccentric exercise. Med Sci Sports Exerc 2003; 35: 892-896.
5 Trappe TA, Fluckey JD, White F. et al. Skeletal muscle PGF(2)(alpha) and PGE(2) in response to eccentric resistance exercise: Influence of ibuprofen acetaminophen. J Clin Endocrinol Metab 2001; 86: 5067-5070.
6 Trappe TA, White F, Lambert CP. et al. Effect of ibuprofen and acetaminophen on postexercise muscle protein synthesis. Am J Physiol Endocrinol Metab 2002; 282: E551-E556.
7 Bondeson BA, Mills ST, Kegley KM. et al. The Cox-2 pathway is essential during early stages of skeletal muscle regeneration. Am J Physiol Cell Physiol 2004; 287: C475-C483.
8 Baldwin AC, Stevenson SW, Dudley GA. Nonsteroidal anti-inflammatory therapy after eccentric exercise in healthy older individuals. J Gerontol A Biol Sci Med Sci 2001; 56: M510-M513.
9 Reuben SS, Ekman EF. The effect of initiating a preventive multimodal analgesic regimen on long-term patient outcomes for outpatient anterior cruciate ligament reconstruction surgery. Anesth Analg 2007; 105: 228-232.
10 Reuben SS, Ekman EF. The effect of cyclooxygenase-2 inhibition on analgesia and spinal fusion. J Bone Joint Surg Am 2005; 87: 536-542.
11 Canapp S, Acciani D, Hulse D. et al. Rehabilitation therapy for elbow disorders in dogs. Vet Surg 2009; 38: 301-317.
12 Jerre S. Rehabilitation after extra-articular stabilisation of cranial cruciate ligament rupture in dogs. Vet Comp Orthop Traumatol 2009; 22: 148-152.
13 Marsolais GS, Dvorak G, Conzemius MG. Effects of postoperative rehabilitation on limb function after cranial cruciate ligament repair in dogs. J Am Vet Med Assoc 2002; 220: 1325-1330.
14 Monk ML, Preston CA, McGowan CM. Effects of early intensive postoperative physiotherapy on limb function after tibial plateau leveling osteotomy in dogs with deficiency of the cranial cruciate ligament. Am J Vet Res 2006; 67: 529-536.
15 Robertson RJ, Goss FL, Boer NF. et al. Children's OMNI scale of perceived exertion: Mixed gender and race validation. Med Sci Sports Exerc 2000; 32: 452-458.
16 Jaegger G, Marcellin-Little DJ, Levine D. Reliability of goniometry in labrador retrievers. Am J Vet Res 2002; 63: 979-986.
17 Pizza FX, Cavender D, Stockard A. et al. Anti-inflammatory doses of ibuprofen: effect on neutrophils and exercise-induced muscle injury. Int J Sports Med 1999; 20: 98-102.
18 Cooper RL, Taylor NF, Feller JA. A randomised controlled trial of proprioceptive and balance training after surgical reconstruction of the anterior cruciate ligament. Res Sports Med 2005; 13: 217-230.
19 Lee HM, Cheng CK, Liau JJ. Correlation between proprioception, muscle strength, knee laxity, and dynamic standing balance in patients with chronic anterior cruciate ligament deficiency. Knee 2009; 16: 387-391.
20 Hudson GM, Green JM, Bishop PA. et al. Effects of caffeine and aspirin on light resistance training performance, perceived exertion, and pain perception. J Strength Cond Res 2008; 22: 1950-1957.
21 Horstman CL, Conzemius MG, Evans R. et al. Assessing the efficacy of perioperative oral carprofen after cranial cruciate surgery using noninvasive, objective pressure platform gait analysis. Vet Surg 2004; 33: 286-292.
22 Hanson PD, Brooks KC, Case J. et al. Efficacy and safety of firocoxib in the management of canine osteoarthritis under field conditions. Vet Ther 2006; 7: 127-140.
23 Beck A, Salem K, Krischak G. et al. Nonsteroidal anti-inflammatory drugs (NSAIDs) in the peri-operative phase in traumatology and orthopedics effects on bone healing. Oper Orthop Traumatol 2005; 17: 569-578.