Dose-dependent efficacy of diclofenac-cholestyramine on pain and periarticular ossifications after total hip arthroplasty: a double-blind, prospective, randomised trial

Authors: Handel, Martin1; Phillips, Oliver2; Anders, Sven3; Köck, Franz3; Sell, Stefan4

Source: Archives of Orthopaedic and Trauma Surgery, Volume 124, Number 7, September 2004 , pp. 483-485(3)

Publisher: Springer

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Abstract:

To investigate the efficacy of treatment with diclofenac-cholestyramine on postoperative pain and functional outcome after total hip arthroplasty, a randomised double-blind study was conducted.

A total of 245 patients received postoperative treatment with 75 mg or 150 mg diclofenac p.o. daily for 14 days.

Patients who received 75 mg diclofenac per day needed paracetamol as an additional analgesic significantly more often (p=0.0162) than patients who were treated with 150 mg diclofenac daily (75 mg twice a day). The incidence of adverse gastrointestinal events was significantly lower in the group receiving 75 mg diclofenac daily than in the group receiving the higher dose (23.1% vs 37.1%; p=0.025). Six months after the operation, no differences were observed between the two groups with regard to pain or functionality measured in terms of overall mobility of the hip. No patient of either group developed clinically relevant heterotopic ossifications.

Treatment with a dose of 75 mg diclofenac once daily—if necessary with the additional use of paracetamol—is a favourable option for the postoperative care of THA.

Keywords: Heterotopic ossification; Diclofenac; Total hip arthroplasty

Document Type: Research article

DOI: 10.1007/s00402-004-0699-9

Affiliations: 1: Department of Orthopedics, University Hospital, Regensburg, Germany, Email: m.handel@rheuma-ortho-zentrum.de 2: Department of Plastic Surgery, Marienhospital, Stuttgart, Germany, 3: Department of Orthopedics, University Hospital, Regensburg, Germany, 4: Department of Orthopedics, Sana Arthritis Hospital, Bad Wildbad, Germany,

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