Celecoxib as Heterotopic Ossification Prophylaxis in Total Ankle Arthroplasty: A Retrospective Cohort Study
Background: This study aimed to determine whether prophylactic celecoxib reduces the prevalence of radiographic heterotopic ossification (HO) following total ankle arthroplasty (TAA). Secondary aims included evaluating its effect on the severity of radiographic HO and its association with patient-re...
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SAGE Publishing
2025-05-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/24730114251337748 |
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| author | Caroline Cristofaro BSc(Hons), MBChB Mohammad Athar MD, MSc, FRCSC Ellie B. Pinsker PhD Brad Meulenkamp MD, MSc, FRCSC Timothy R. Daniels MD, FRCSC Mansur M. Halai BSc(Hons), MBCBhB, MRCA, MRCS, FRCS(Tr&Orth) |
| author_facet | Caroline Cristofaro BSc(Hons), MBChB Mohammad Athar MD, MSc, FRCSC Ellie B. Pinsker PhD Brad Meulenkamp MD, MSc, FRCSC Timothy R. Daniels MD, FRCSC Mansur M. Halai BSc(Hons), MBCBhB, MRCA, MRCS, FRCS(Tr&Orth) |
| author_sort | Caroline Cristofaro BSc(Hons), MBChB |
| collection | DOAJ |
| description | Background: This study aimed to determine whether prophylactic celecoxib reduces the prevalence of radiographic heterotopic ossification (HO) following total ankle arthroplasty (TAA). Secondary aims included evaluating its effect on the severity of radiographic HO and its association with patient-reported outcome measures (PROMs). Methods: This retrospective cohort study included all patients who underwent a primary TAA between April 2019 to May 2023 at a single academic institution. The intervention group was composed of patients prescribed 4 weeks of celecoxib postoperatively and was compared to controls who received no celecoxib. Radiographs at ≥8 months were reviewed and graded using the modified Brooker classification for severity of HO. Ankle Osteoarthritis Score pain and disability, 36-Item Short Form Health Survey physical function and mental health were assessed at follow-up. Results: One hundred seventy-nine patients, 95 males (53.1%) and 84 females (46.9%), were included. The mean age was 65.8 ± 9.6 years. Ninety patients (50.3%) received celecoxib and 89 (49.7%) did not. The prevalence of HO at the time of follow-up (1.2 ± 0.4 years) was 53 (29.6%) with grade 0, 78 (43.6%) with grade 1, 21 (11.7%) with grade 2, 21 (11.7%) with grade 3, and 6 (3.4%) with grade 4. Patients who did not receive celecoxib were significantly more likely to develop HO and experience greater severity of HO, with odds ratios of 2.19 (95% CI 1.10-4.33, P < .05) and 2.51 (95% CI 1.43-4.44, P < .05), respectively. No significant differences in patient-reported outcomes were observed between groups. Conclusion: Celecoxib for 4 weeks postoperatively may reduce the risk and severity of HO after TAA without affecting patient-reported outcomes. HO prophylaxis did not have a statistically significant impact on PROMs. Celecoxib for HO prophylaxis can be considered following primary TAA while balancing the risks of side effects. Level of Evidence: Level III, (retrospective cohort study). |
| format | Article |
| id | doaj-art-c9c5ab1bafa245ea85374debf2796adb |
| institution | OA Journals |
| issn | 2473-0114 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | SAGE Publishing |
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| series | Foot & Ankle Orthopaedics |
| spelling | doaj-art-c9c5ab1bafa245ea85374debf2796adb2025-08-20T02:01:24ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142025-05-011010.1177/24730114251337748Celecoxib as Heterotopic Ossification Prophylaxis in Total Ankle Arthroplasty: A Retrospective Cohort StudyCaroline Cristofaro BSc(Hons), MBChB0Mohammad Athar MD, MSc, FRCSC1Ellie B. Pinsker PhD2Brad Meulenkamp MD, MSc, FRCSC3Timothy R. Daniels MD, FRCSC4Mansur M. Halai BSc(Hons), MBCBhB, MRCA, MRCS, FRCS(Tr&Orth)5Department of Surgery, University of Toronto, Toronto, ON, CanadaComplete Orthopedics, Stony Brook, NY, USADivision of Orthopaedic Surgery, Department of Surgery, Unity Health Toronto–St. Michael’s Hospital, Toronto, ON, CanadaDivision of Orthopaedic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, ON, CanadaDivision of Orthopaedic Surgery, Department of Surgery, Unity Health Toronto–St. Michael’s Hospital, Toronto, ON, CanadaDivision of Orthopaedic Surgery, Department of Surgery, Unity Health Toronto–St. Michael’s Hospital, Toronto, ON, CanadaBackground: This study aimed to determine whether prophylactic celecoxib reduces the prevalence of radiographic heterotopic ossification (HO) following total ankle arthroplasty (TAA). Secondary aims included evaluating its effect on the severity of radiographic HO and its association with patient-reported outcome measures (PROMs). Methods: This retrospective cohort study included all patients who underwent a primary TAA between April 2019 to May 2023 at a single academic institution. The intervention group was composed of patients prescribed 4 weeks of celecoxib postoperatively and was compared to controls who received no celecoxib. Radiographs at ≥8 months were reviewed and graded using the modified Brooker classification for severity of HO. Ankle Osteoarthritis Score pain and disability, 36-Item Short Form Health Survey physical function and mental health were assessed at follow-up. Results: One hundred seventy-nine patients, 95 males (53.1%) and 84 females (46.9%), were included. The mean age was 65.8 ± 9.6 years. Ninety patients (50.3%) received celecoxib and 89 (49.7%) did not. The prevalence of HO at the time of follow-up (1.2 ± 0.4 years) was 53 (29.6%) with grade 0, 78 (43.6%) with grade 1, 21 (11.7%) with grade 2, 21 (11.7%) with grade 3, and 6 (3.4%) with grade 4. Patients who did not receive celecoxib were significantly more likely to develop HO and experience greater severity of HO, with odds ratios of 2.19 (95% CI 1.10-4.33, P < .05) and 2.51 (95% CI 1.43-4.44, P < .05), respectively. No significant differences in patient-reported outcomes were observed between groups. Conclusion: Celecoxib for 4 weeks postoperatively may reduce the risk and severity of HO after TAA without affecting patient-reported outcomes. HO prophylaxis did not have a statistically significant impact on PROMs. Celecoxib for HO prophylaxis can be considered following primary TAA while balancing the risks of side effects. Level of Evidence: Level III, (retrospective cohort study).https://doi.org/10.1177/24730114251337748 |
| spellingShingle | Caroline Cristofaro BSc(Hons), MBChB Mohammad Athar MD, MSc, FRCSC Ellie B. Pinsker PhD Brad Meulenkamp MD, MSc, FRCSC Timothy R. Daniels MD, FRCSC Mansur M. Halai BSc(Hons), MBCBhB, MRCA, MRCS, FRCS(Tr&Orth) Celecoxib as Heterotopic Ossification Prophylaxis in Total Ankle Arthroplasty: A Retrospective Cohort Study Foot & Ankle Orthopaedics |
| title | Celecoxib as Heterotopic Ossification Prophylaxis in Total Ankle Arthroplasty: A Retrospective Cohort Study |
| title_full | Celecoxib as Heterotopic Ossification Prophylaxis in Total Ankle Arthroplasty: A Retrospective Cohort Study |
| title_fullStr | Celecoxib as Heterotopic Ossification Prophylaxis in Total Ankle Arthroplasty: A Retrospective Cohort Study |
| title_full_unstemmed | Celecoxib as Heterotopic Ossification Prophylaxis in Total Ankle Arthroplasty: A Retrospective Cohort Study |
| title_short | Celecoxib as Heterotopic Ossification Prophylaxis in Total Ankle Arthroplasty: A Retrospective Cohort Study |
| title_sort | celecoxib as heterotopic ossification prophylaxis in total ankle arthroplasty a retrospective cohort study |
| url | https://doi.org/10.1177/24730114251337748 |
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