What is it about?

This meta-analysis aims to determine whether non-steroidal anti-inflammatory drug (NSAID) use is significantly associated with adverse bone healing outcomes within clinical settings, including trauma and elective spine settings. It will also explore bone healing outcomes with the type, route, dosage and duration of NSAID exposure and aims to demonstrate the effects of various other confounding factors on bone healing outcomes.

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Why is it important?

This current analysis attempts to provide a detailed account of all available research with aims to highlight the risk of bone healing complications with NSAID exposure during the postoperative period. It incorporates two fair-quality case-control studies, 11 fair and moderate-quality retrospective cohort studies and two good-quality prospective randomised trials. The meta-analysis involves distinct analysis of observational long bone and spine studies in the adult population, while observational studies from the paediatric population and randomised trials underwent separate assessment in terms of clinical and practical importance. Finally, in addition to addressing some of the limitations highlighted by the relevant meta-analysis in the past, the current synthesis considers the potential impediments to a few source studies included in the meta-analysis.


This meta-analysis presents useful information regarding the significant association of bone healing complications with perioperative exposure to NSAIDs, based on the assessment of available fair-quality long bone studies and moderate-quality spine studies on the adult population. However, attempts to conduct high-quality prospective cohort and randomised trials to study the effects of NSAID use on bone healing would be very helpful and will provide a basis for more extensive research in future.

Muhammad Ali
Health Education England, North West Deanery

Read the Original

This page is a summary of: Effects of NSAID use on bone healing: A meta-analysis of retrospective case–control and cohort studies within clinical settings, Trauma, November 2019, SAGE Publications, DOI: 10.1177/1460408619886211.
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