For anyone who has been using the new class of anti-inflammatory (COX-2
inhibitor) drugs such as Celecoxib, the following research should be
interesting. It showed that Celecoxib, unlike older anti-inflammatories
like aspirin, decreases ligament healing strength by 32 percent, at least in
the animal study concerned.
Non-aspirin pain drug may slow ligament healing
< http://www.eurekalert.org/pub_releases/2001-11/uonc-npd111501.php>
CHAPEL HILL - A new class of non-aspirin pain medicine now widely prescribed
for arthritis symptoms may impair ligament healing associated with sprains,
according to laboratory findings at the University of North Carolina at
Chapel Hill.
The newer medications, cyclooxygenase-2 specific inhibitors, or COX-2
inhibitors, are the latest nonsteroidal anti-inflammatory drugs. COX-2
inhibitors are marketed as having the same effectiveness against pain and
swelling of inflammation as the older NSAIDs but without the increased risk
of gastrointestinal side effects, including stomach ulcers, which have been
linked to NSAID use. The newer drugs are sold in the United States under the
brand names Celebrex and Vioxx.
A report of the new findings appears in the November 14 issue of the American
Journal of Sports Medicine.
Dr. Lawrence E. Dahners, professor of orthopedics at UNC-CH School of
Medicine, said he and his UNC co-authors, Drs. Christopher L. Elder and Paul
S. Weinhold, were not aware of any research highlighting the effects of COX-2
inhibitors on soft tissue injuries such as sprains. They noted that among the
widest uses of nonsteroidal anti-inflammatory drugs is in the treatment of
such injuries.
"And so the question came up whether it was good to prescribe COX-2
inhibitors for patients who were getting sprains," Dahners said. The Carolina
orthopedist noted that previous studies in the 1980s had shown that
anti-inflammatory drugs were bad for bone healing and shouldn't be given to
patients with fractures. "We then did a study to examine the effects of
nonsteroidals [NSAIDS] on ligament healing. To our surprise, we found they
made ligaments heal better. Therefore, they were very good medications for
people with sprains, sprains being ligament injuries," Dahners said.
Thus, with the advent of COX-2 inhibitors, and given a dearth of research on
their role in ligament healing, Dahners and his colleagues decided to
investigate this issue. The study in rats involved an experimental model for
an acute injury of the medial collateral ligament. In humans, the MCL runs up
the inside of the knee and is the most common site of knee sprains.
Postoperatively, half the animals were given the COX-2 inhibitor celecoxib
for the first six days of recovery, the other half were not. About two weeks
later, the injured and uninjured ligaments were tested for healing strength.
Celecoxib decreased ligament healing strength by 32 percent. Dahners points
out that some of the older NSAIDS block two enzymes associated with pain and
inflammation: cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). In
previous studies, he found that these medications actually increased the
strength of ligament healing by roughly 40 percent.
"This would indicate that if you had a soft tissue injury -- hurt your back,
sprained your ankle --you probably should try to take the older
anti-inflammatory drugs rather than the new ones, unless your stomach is
sensitive to those medications," Dahners advised.
Still, he cautioned that the findings remain preliminary. The long-term
outcome of COX-2 inhibitors on ligament healing needs further study, as does
further clarification of the roles of the enzymes COX-1 and -2 on soft tissue
related to muscle and bone.
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Dr Mel C Siff
Denver, USA
http://groups.yahoo.com/group/Supertraining/
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