Effect of NSAIDs on Bone Healing Rates: A Meta-analysis

Benjamin M. Wheatley*, Kyle E. Nappo, Daniel L. Christensen, Ann M. Holman, Daniel I. Brooks, Benjamin K. Potter

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

112 Scopus citations

Abstract

Introduction: NSAIDs inhibit osteogenesis and may result in delayed union or nonunion. The purpose of this meta-analysis was to determine whether their use leads to delayed union or nonunion. Methods: We systematically reviewed the literature reporting the effect of NSAIDs on bone healing. We included studies of pediatric and adult patients NSAID exposure and healing bone. The outcomes of interest were delayed union, nonunion, or pseudarthrosis with at least six months of follow-up. A maximum likelihood random-effects model was used to conduct meta-analysis and meta-regression. Results: NSAID exposure increased delayed union or nonunion (odds ratio [OR], 2.07; confidence interval [CI], 1.19 to 3.61). No effect was noted in pediatrics (OR, 0.58; CI, 0.27 to 1.21) or low dose/short duration of exposure (OR, 1.68; CI, 0.63 to 4.46). Conclusion: Analysis of the literature indicates a negative effect of NSAIDs on bone healing. In pediatric patients, NSAIDs did not have a significant effect. The effect may be dose or time dependent because low-dose/short-duration exposure did not affect union rates.

Original languageEnglish
Pages (from-to)E330-E336
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Volume27
Issue number7
DOIs
StatePublished - 1 Apr 2019
Externally publishedYes

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