Indomethacin may increase the risk of heterotopic ossification after distal biceps repair

CHICAGO — Patients treated with indomethacin after a two-incision distal biceps repair experienced eight-times greater odds of developing heterotopic ossification, according to results presented here.

Raffy Mirzayan , MD, and colleagues recorded demographic information, time from injury to surgery, tourniquet time and development of heterotopic ossification among patients who underwent a two-incision distal biceps repair. Researchers identified patients who were prescribed any NSAIDs and reviewed medical records to confirm compliance of indomethacin.

Of the 784 patients who underwent distal biceps repair, 146 patients underwent two-incision repair. Of these, Mirzayan noted 45 had postoperative X-rays. Of these patients, 14 were treated with indomethacin and 31 were in the control group.

“There was a significant difference in the age, in the controls being 10 years older compared to the indomethacin group, but there was no difference [in] time from injury to surgery, tourniquet time, time from surgery to the last X-ray and percentage of smokers,” Mirzayan said in his presentation at the American Shoulder and Elbow Surgeons Annual Meeting.

Results showed 42.9% and 22.6% of patients in the indomethacin group and control group, respectively, developed heterotopic ossification. Researchers found no differences in low- vs. high-dose of medication or length of treatment.

“Using [an] age-adjusted logistic regression model, patients who were treated with indomethacin had an eight-times higher rate of [heterotopic ossification] HO development compared to controls,” Mirzayan said. – by Casey Tingle

Reference:

Hudson JD, et al. Paper 8. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Oct. 12-14, 2018; Chicago.

Disclosure: Mirzayan reports he receives stock or stock options from AlignMed; is on the editorial or governing board for the American Journal of Orthopedics; is a paid presenter or speaker for Arthrex Inc.; receives research support from Arthrex Inc. and Joint Restoration Foundation; and receives publishing royalties, financial or material support from Springer, Thieme and Wolters Kluwer Health – Lippincott Williams & Wilkins.