Dr. Prodromos ACL Blog August 2017
It is well established that Non-Steroidal Anti-inflammatory Drugs (NSAIDs) such as ibuprofen (motrin, advil), naproxen (aleve), aspirin, celebrex, diclofenac, and meloxicam interfere with the healing of ligaments, bones, tendons and other connective tissue. For this reason Orthopaedic Surgeons are cautious in their use after reconstructive surgery and in other applications - although there are few clinical studies showing the effect of NSAIDs on outcomes. However, a recent paper entitled Predictors of Revision Surgery After Anterior Cruciate Ligament Reconstruction from the US Navy published in the American Journal of Sportsmedicine found a significant correlation with the use of NSAIDs and an increased rate of revision, i.e. failure, after ACL reconstruction. This held true for both so-called COX-1 NSAIDs, the vast majority available, and also COX-2 NSAIDs which include Celebrex and Meloxicam. The authors write “Increased odds of revision surgery among active-duty personnel were associated with the perioperative use of NSAIDs and COX-2 inhibitors.” This reinforces the conclusion found in one of the few other papers to look at this topic The effect of ketorolac on anteroposterior knee laxity after anterior cruciate ligament reconstruction. where it was found that “The use of ketorolac during bone-patellar tendon autograft ACL reconstruction was associated with increased AP laxity at 6 weeks postoperatively.”
