Non-steroidal anti-inflammatory drugs inhibit bone healing: a review.
Abstract: The ability of non-steroidal anti-inflammatory drugs (NSAID) to inhibit bone healing has been established in experimental animal models using mice, rats, and rabbits. The mechanism of action is largely unknown but stems from prostaglandin inhibition and is likely multifactorial. In human medicine NSAID are known to prevent heterotopic ossification, however the clinical importance of their effects on bone healing remains controversial. Although a small handful of reports suggest that NSAID suppress bone healing in dogs and horses, there is little published information to direct veterinary practice in domestic species.
Publication Date: 2010-09-09 PubMed ID: 20830450DOI: 10.3415/VCOT-10-01-0017Google Scholar: Lookup
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- Journal Article
- Review
Summary
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The research article discusses how non-steroidal anti-inflammatory drugs (NSAIDs) are known to inhibit bone healing, however, the exact mechanism of how this happens is still largely unknown.
Investigations on Animal Models
- The research article reveals that studies on experimental animal models, specifically mice, rats, and rabbits, have confirmed that non-steroidal anti-inflammatory drugs (NSAIDs) can inhibit bone healing.
- The mechanism through which NSAIDs negatively affect bone healing is, for the most part, not well understood. However, it is suggested to stem largely from prostaglandin inhibition. Prostaglandins are known to play a crucial role in inflammation, which is a key part of the bone healing process. Therefore, the suppression of prostaglandins by NSAIDs is likely to interfere with normal bone recovery.
- Furthermore, it is suggested that the way NSAIDs affect bone healing is probably multifactorial, meaning it involves various biological processes and not just prostaglandin inhibition.
Implications on Human Medicine
- In the context of human medicine, it’s known that NSAIDs prevent heterotopic ossification. This is a condition where bone tissue forms outside the skeletal system, commonly following a major surgery or injury. While this prevention might seem beneficial on the surface, NSAIDs’ effects on the normal bone healing process is a matter of ongoing controversy.
- Although some reports indicate that NSAID usage has a suppressive effect on bone healing in human scenarios, the overall clinical importance of these effects remains disputed, necessitating further research.
Implications on Veterinary Practice
- The article also touches on the implications of NSAID usage in veterinary practice. A few reports suggest that NSAIDs might suppress bone healing in non-human patients, such as dogs and horses. However, not much information is available to guide veterinary practices regarding NSAID usage in domestic species.
- The potential impact of NSAIDs on bone healing in veterinary contexts, therefore, remains a largely unexplored area. More research is thus necessary to clearly understand the implications and establish guidelines for best practices.
Cite This Article
APA
Barry S.
(2010).
Non-steroidal anti-inflammatory drugs inhibit bone healing: a review.
Vet Comp Orthop Traumatol, 23(6), 385-392.
https://doi.org/10.3415/VCOT-10-01-0017 Publication
Researcher Affiliations
- Washington State University, Department of Veterinary Clinical Sciences, Veterinary Teaching Hospital, PO Box 647060, Pullman, WA 99164-7060, USA. barrys@vetmed.wsu.edu
MeSH Terms
- Animals
- Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
- Bone Diseases / drug therapy
- Bone Diseases / veterinary
- Dogs
- Dose-Response Relationship, Drug
- Fractures, Bone / drug therapy
- Fractures, Bone / veterinary
- Humans
- Mice
- Rabbits
- Rats
- Spinal Fusion / methods
- Wound Healing / drug effects
Citations
This article has been cited 16 times.- Nikolaisen NK, Colding-Rasmussen T, Horstmann PF, Müller AV, Cerón JJ, Petersen MM, Tierp-Wong CNE, Jacobsen S. First steps in the development of an ovine proximal phalanx fracture and bone defect model: a study of animal welfare and bone healing. Front Vet Sci 2025;12:1662553.
- Chang M, Kasper A, Chung J, Wright J, Pennington M, Ilyas AM. The Effect of Nonsteroidal Anti-Inflammatory Drugs on Union Rates Following Operative Repair of Distal Radius Fractures. J Hand Surg Glob Online 2025 Jul;7(4):100720.
- Çelik M, Karaduman ZO, Turhan Y, Arıcan M, Gamsızkan M, Saglam S, Uludag V. The Effects of Phenyramidol and Diclofenac Treatment on Fracture Healing in Rats. Clin Orthop Surg 2024 Oct;16(5):836-844.
- Radenkovs V, Valdovska A, Galina D, Cairns S, Jakovlevs D, Gaidukovs S, Cinkmanis I, Juhnevica-Radenkova K. Elaboration of Nanostructured Levan-Based Colloid System as a Biological Alternative with Antimicrobial Activity for Applications in the Management of Pathogenic Microorganisms. Nanomaterials (Basel) 2023 Nov 17;13(22).
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- Hadjicharalambous C, Alpantaki K, Chatzinikolaidou M. Effects of NSAIDs on pre-osteoblast viability and osteogenic differentiation. Exp Ther Med 2021 Jul;22(1):740.
- Xu X, Zhang J, Filion TM, Akalin A, Song J. Modulating Mechanical and Shape-Memory Properties while Mitigating Degradation-Induced Inflammation of Polylactides by Pendant Aspirin Incorporation. ACS Appl Mater Interfaces 2021 May 19;13(19):22271-22281.
- Ghiasi MS, Chen JE, Rodriguez EK, Vaziri A, Nazarian A. Computational modeling of human bone fracture healing affected by different conditions of initial healing stage. BMC Musculoskelet Disord 2019 Nov 25;20(1):562.
- Hjorthaug GA, Søreide E, Nordsletten L, Madsen JE, Reinholt FP, Niratisairak S, Dimmen S. Short-term perioperative parecoxib is not detrimental to shaft fracture healing in a rat model. Bone Joint Res 2019 Oct;8(10):472-480.
- Huss MK, Felt SA, Pacharinsak C. Influence of Pain and Analgesia on Orthopedic and Wound-healing Models in Rats and Mice. Comp Med 2019 Dec 1;69(6):535-545.
- Berry JAD, Miulli DE, Lam B, Elia C, Minasian J, Podkovik S, Wacker MRS. The neurosurgical wound and factors that can affect cosmetic, functional, and neurological outcomes. Int Wound J 2019 Feb;16(1):71-78.
- Franklin SP, Burke EE, Holmes SP. The effect of platelet-rich plasma on osseous healing in dogs undergoing high tibial osteotomy. PLoS One 2017;12(5):e0177597.
- Martinez SE, Chen Y, Ho EA, Martinez SA, Davies NM. Pharmacological effects of a C-phycocyanin-based multicomponent nutraceutical in an in-vitro canine chondrocyte model of osteoarthritis. Can J Vet Res 2015 Jul;79(3):241-9.
- Mantyh PW. The neurobiology of skeletal pain. Eur J Neurosci 2014 Feb;39(3):508-19.
- Oh N, Kim S, Hosoya K, Okumura M. Compensatory cellular reactions to nonsteroidal anti-inflammatory drugs on osteogenic differentiation in canine bone marrow-derived mesenchymal stem cells. J Vet Med Sci 2014 May;76(5):629-36.
- Pivonka P, Dunstan CR. Role of mathematical modeling in bone fracture healing. Bonekey Rep 2012 Nov 14;1:221.
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