Results of an Australasian randomised, placebo-controlled trial have challenged the recommendation that all patients undergoing total hip replacement should take a short course of postoperative NSAIDs to prevent residual symptoms by preventing ectopic bone formation in the soft tissues around the operated hip. The trial involved 902 patients undergoing elective primary or revision total hip replacement surgery who were randomly assigned to receive 14 days’ treatment with either ibuprofen (1200 mg daily) or placebo, starting within 24 hours of surgery. While postoperative ibuprofen reduced ectopic bone formation after the surgery, this does not translate into less pain or disability 6 to 12 months after surgery. There was also an increased risk of major bleeding complications in the ibuprofen group during admission. The researchers said that their findings provided evidence that clinical care guidelines should be based on clinically important outcomes rather than unproven surrogate outcomes, like radiographic ectopic bone formation.
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