Introduction: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to delay fracture healing in experimental models and received scrutiny in human medicine due to NSAIDs being identified as a risk factor of delayed- and nonunions. The effects of NSAIDs on fracture healing in veterinary medicine using FDA approved drugs are limited. The study objective was to determine if short-term NSAIDs use would delay bone healing. We hypothesized no difference would be seen between dogs given no NSAIDs and 2 weeks of NSAIDs, but 8 weeks of NSAIDs would delay bone healing.
Materials and Methods: An 8-week study was performed following tibial osteotomy in 18 dogs. Fracture healing was evaluated using radiographs, biomechanical strength, histological cartilage: callus ratio, and bone mineral density with quantitative CT.
Results: Some, but not all biomechanical measures (stiffness, maximum stress) showed 0- and 8-week NSAID groups were different, but no further differences could be demonstrated between any groups. Radiographic healing score both 4 weeks and 8 weeks postop was the not different (i.e., equivalently healed) for the 0- and 2-week NSAIDs group, but less healed for the 8-week group. There was no effect of treatment on cartilage, callus ratio, or bone mineral density.
Discussion/Conclusion: Limitations include small sample size, superficial infection rate (58%), and simplicity of fracture model. Biomechanical strength, radiographic union, histopathology, and bone mineral density demonstrated short-term NSAID usage did not affect healing in this study. Caution should be exercised when using NSAIDs in postoperative fracture patients at risk for delayed healing.
Acknowledgment: This project was funded by a 2016 ACVS Foundation Surgeon-In-Training Research Grant.
