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This Article Full Text Full Text (PDF) All Versions of this Article: 32/7/1743    most recent 0363546504263403v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (10) Citing Articles via Google Scholar Google Scholar Articles by Virchenko, O. Articles by Aspenberg, P. Search for Related Content PubMed PubMed Citation Articles by Virchenko, O. Articles by Aspenberg, P. Related Collections Reconstruction Achilles tendon

Parecoxib Impairs Early Tendon Repair but Improves Later Remodeling

From the Section for Orthopaedics and Sports Medicine, Department of Neuroscience and Locomotion, Faculty of Health Sciences, Linköping, Sweden

^* Address correspondence to Per Aspenberg, MD, PhD, Section for Orthopaedics and Sports Medicine, Department of Neuroscience and Locomotion, Faculty of Health Sciences, SE-581 85 Linköping, Sweden (e-mail: per.aspenberg{at}inr.liu.se).

Background: Cyclooxygenase-2 inhibitors inhibit bone repair.

Hypothesis: Cyclooxygenase inhibitors might also have a negative effect on early tendon repair, although a positive effect on late tendon repair previously has been shown.

Study Design: Controlled laboratory study.

Methods: Achilles tendon transection was performed on 80 rats. Sixty rats were given daily intramuscular injections of either parecoxib (6.4 mg/kg body weight) or saline for the first 5 days after surgery and sacrificed either at 8 or 14 days. The remaining 20 rats were given intramuscular parecoxib or saline injections from day 6 until sacrifice at 14 days.

Results: At 8 days, early parecoxib treatment caused a 27% decrease in force at failure (P = .007), a 25% decrease in maximum stress (P = .01), and a 31% decrease in energy uptake (P = .05). Stiffness and transverse area were not significantly affected. At 14 days, early parecoxib treatment caused a decrease in stiffness (P = .004). In contrast to early treatment, late parecoxib treatment caused a 16% decrease in cross-sectional area (P = .03) and a 29% increase in maximum stress (P = .04).

Conclusions: During early tendon repair, a cyclooxygenase-2 inhibitor had a detrimental effect. During remodelling, however, inflammation appears to have a negative influence, and cyclooxygenase-2 inhibitors might be of value.

Clinical Relevance: The results suggest that cyclooxygenase-2 inhibitors should be used with care in the early period after tendon injury.

Key Words: nonsteroidal anti-inflammatory drug (NSAID) • tendon repair • ligament • rat • remodeling

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