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Volume 3
Pulsus Journal of Surgical Research
Osteoporosis 2019
March 13-14, 2019
Osteoporosis, Arthritis and Musculoskeletal Disorders
March 13-14, 2019, London, UK
12
th
International Conference on
Effects of NSAID use on bone healing: A meta-analysis of cohort studies and randomised controlled trial
within clinical settings
Muhammad Usman Ali
1
and Mehvish Hayat
2
1
Royal Preston Hospital, UK
2
Manchester Royal Infirmary, UK
T
his unique meta-analysis aims to determine whether Non-Steroidal Anti-Inflammatory Drugs (NSAID) use is significantly
associated with poor bone healing outcomes within clinical settings and to further highlight whether such association is more
significant for non-union or delayed union of fractures. It will further explore bone healing outcomes in relation to the type, route,
dosage and duration of NSAID exposure and aims to demonstrate modifying evidence effects of patients’ age, smoking status, diabetes,
site of fracture and length of follow-up to diagnosis on bone healing outcomes. MedLine, Embase and Cochrane electronic databases
were searched electronically, and search period included January 1975 to December 2017. Observational studies and randomised
trials involving effects of NSAID exposure on fracture healing and spinal fusion were considered for non-union and delayed bone
union. Meta-analysis was performed in compliance with QUORUM and PRISMA guidelines. In the initial analysis of pooled data
from 15 studies including randomised trials and cohort studies, results suggested significant risk of poor bone healing in patients with
NSAID use (OR = 2.45, 95% CI 1.57-3.82, p < 0.0001). Meta-regression further suggested significant poor outcomes in relation to oral
route (OR = 4.34, 95% CI 2.50-7.55, p < 0.00001), extended duration of NSAID exposure (OR = 2.64, 95% CI 1.41-4.91, p = 0.002)
and across all bone types (OR = 2.71, 95% CI 1.74-4.22, p < 0.0001). Smoking was a significant confounder associated with poor bone
healing (OR = 2.55, 95% CI 2.12-3.07, p < 0.00001). The current synthesis incorporates high-quality randomized controlled trials and
retrospective cohort studies; however, it lacks decent quality prospective cohort studies due to their non-existence within available
literature. This highlights the need for further high-quality randomized controlled trials or prospective cohort studies assessing
NSAID exposure on bone healing that will also provide basis for more extensive meta-analysis in future.
Biography
Ali and Hayat are currently undergoing their training in Trauma and Orthopaedics Surgery in North West region, UK. Through-out his undergraduate and
postgraduate career, Ali had been involved in extensive research and is author to several international publications and monographs. Hayat completed her masters
in Orthopaedics and Trauma Science and thrives to contribute to ongoing research in the subject. Authors unique and robust work on role of NSAID use on bone
healing provides a cornerstone for future research to highlight effects of NSAID use on fracture healing and spinal fusion. This extensive project will be of interest
to a wide variety of readers including medical practitioners, orthopaedic surgeons, and emergency medicine doctors while considering use of NSAIDs for pain
management in patients with fractures.
drusman012@gmail.com, mawish.hayat@gmail.comPulsus J Surg Res, Volume 3