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Subject-specific Musculoskeletal Model for Studying Bone Strain During Dynamic Motion
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Regular Nonsteroidal Anti-Inflammatory Drug Use Increases Stress Fracture Risk in the General Population: A

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Area of Science:

  • Orthopedics
  • Pharmacology
  • Epidemiology

Background:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with increased stress fracture risk, primarily studied in athletes.
  • Limited data exist on NSAID use and stress fractures in the general population, despite significant public health impact.
  • Preclinical studies suggest NSAIDs may impair bone's intrinsic fracture resistance.

Purpose of the Study:

  • To investigate the association between regular NSAID use and stress fractures in the general population.
  • To compare NSAID usage patterns between individuals with stress fractures and a control group.

Main Methods:

  • A case-control study surveyed 56 individuals with stress fractures and 51 controls (uncomplicated ankle sprains).
  • NSAID use (current and regular) in the three months prior to injury was assessed using a validated questionnaire.
  • Fisher's exact test was employed to analyze differences in NSAID usage between groups.

Main Results:

  • Individuals with stress fractures showed a statistically significant increase in current and regular use of ibuprofen, naproxen, and celecoxib compared to controls.
  • No significant differences were found in the use of aspirin, acetaminophen, or acetaminophen-containing prescription drugs.
  • A strong correlation was observed between regular use of specific NSAIDs and stress fracture incidence.

Conclusions:

  • Regular use of ibuprofen, naproxen, or celecoxib is associated with a higher incidence of stress fractures in the general population.
  • These findings support previous clinical observations and highlight a potential risk factor for bone injury.
  • Patients identified as high-risk for stress fractures should consider avoiding regular use of these common NSAIDs.