Pharmacological agents and impairment of fracture healing: what is the evidence?

  title={Pharmacological agents and impairment of fracture healing: what is the evidence?},
  author={Ippokratis Pountos and Theodora Georgouli and Taco JM Blokhuis and H C Pape and Peter V. Giannoudis},
  volume={39 4},

Tables from this paper

NSAIDs and fracture healing
Concerns about the use of nonselective NSAIDs and selective cyclo-oxygenase (COX)-2 inhibitors as anti-inflammatory or analgesic drugs in patients after a recent fracture or who are undergoing (uncemented) arthroplasty or osteotomy are raised.
Anti-osteoporosis therapy and fracture healing
There are still large gaps in the understanding of the potential effect of anti-osteoporotic drugs on fracture healing, although based on present knowledge a recent or present fracture should not be considered as a contraindication to such treatment.
Fracture Healing: Back to Basics and Latest Advances
The aim of this chapter is to present the fundamental principles of fracture healing, factors that can influence it adversely, and key approaches to stimulate a successful fracture healing response.
The effect of nonsteroidal anti-inflammatory drug administration on acute phase fracture-healing: a review.
The balance of evidence in the available literature appears to suggest that a short-duration NSAID regimen is a safe and effective supplement to other modes of post-fracture pain control, without a significantly increased risk of sequelae related to disrupted healing.
Effects of NSAIDs on pre-osteoblast viability and osteogenic differentiation.
Evidence is provided that NSAIDs may adversely affect the viability of mouse pre-osteoblast cells but their actions on the osteogenic differentiation are drug-specific, which may place some NSAIDs in a preferential position for analgesic and anti-inflammatory therapy during bone repair.
Adjuvant drug-assisted bone healing: Part I - Modulation of inflammation.
This work critically examined the hypothesis that targeted adjuvant therapies have the potential to enhance bone regeneration in critical-size bone defects and under systemic conditions that impair bone healing to stimulate further research on bone healing under critical conditions.
Mechanisms Underlying Normal Fracture Healing and Risk Factors for Delayed Healing
Interest is high for exploring currently available osteoporosis therapies for efficacy in fracture repair and definitive data supporting their efficacy are essential in achieving approval for this indication.
Pharmacological agents and bone healing.
Preclinical studies have shown that certain pharmacological agents may enhance osseointegration and stimulate reparative processes and may represent a valuable aid in the treatment of fractures.


Fracture healing.
  • R. CruessJ. Dumont
  • Medicine
    Canadian journal of surgery. Journal canadien de chirurgie
  • 1975
The sequence of events occurring after fracture is now relatively well understood. Healing takes place in three phases--inflammatory, reparative and remodelling. In each phase certain cells
Prevention of fracture healing in rats by an inhibitor of angiogenesis.
Effects on fracture healing of an antagonist of the vitamin K cycle
SummaryThe anticoagulant, dicumarol, inhibits the vitamin K cycle by blocking the conversion of the vitamin K epoxide. The effects of dicumarol on ossification have been tested by feeding it to rats
Effect of COX-2-specific inhibition on fracture-healing in the rat femur.
Postoperative administration of celecoxib, a COX-2-specific inhibitor, did not delay healing as seen at twelve weeks following fracture in adult rat femora, suggesting that the effect of nonsteroidal anti-inflammatory medications has been shown to delay fracture union.
Use of a bisphosphonate (pamidronate) to modulate fracture repair in ovine bone.
It is indicated that pamidronate has no adverse effects on the restoration of the mechanical integrity of a long bone after fracture, as bisphosphonates act to reduce callus remodelling, leading to an increased amount of bridging callus and therefore strength.
Effects of short-term treatment with corticosteroids and indomethacin on bone healing
Indomethacin inhibited healing when estimated by mechanical tests of bending moment, energy expenditure before refracture, and bending rigidity 6 weeks after surgery, while short-term methylprednisolone inhibited healing.
The effect of anticoagulant therapy on bone repair.
It is not the authors' intention to conclude from this study that non-union will necessarily occur in a patient who has received anticoagulant therapy; they feel, however, that the possibility of its occurring must be considered.
Cyclooxygenase-2 inhibitor inhibits the fracture healing.
It was concluded that etodolac, a cox-2 specific inhibitor, inhibited fracture healing after closed non-displaced fractures were created in 12-week-old Wister rats.
The effect of indomethacin upon experimental fractures in the rat.
It was found that the drug had no significant effect upon new bone formation in heterotopic bone grafts and a significant impairment of osteogenesis was detected in older animals given continuous treatment with Indomethacin from the week before fracture.