Effects of ketoralac tromethamine and indomethacin on primary and secondary bone healing. An experimental study in...

Ketoralac tromethamine is a new non-steroidal anti-inflammatory drug that is being used extensively as an analgesic in orthopaedic surgery, particularly for outpatient procedures. However, as with all non-steroidal anti-inflammatory drugs there have been theoretical concerns about the effect of the drug with regard to bone metabolism and healing. In the present study bone healing of femoral osteotomies was evaluated in rats given ketoralac tromethamine in comparison with two other groups of rats given indomethacin and saline (control group), respectively. Under unstable healing conditions, 3 days of medication with indomethacin significantly reduced the femoral bending moment, bending rigidity and energy expenditure compared with the control group. Such impairment of mechanical characteristics was not found during the first 3 days after osteotomy in rats given ketoralac tromethamine. There were no significant differences in mechanical properties between the three groups when healing occurred under stable conditions. Ketoralac tromethamine is a rather new NSAID that has excellent aqueous solubility and lacks tissue irritability [2]. It is, therefore, very suitable for parenteral use. Additionally, it is the most potent NSAID known, equal or superior to morphine for pain relief following orthopaedic surgery [9]. Its use has therefore become widespread as an alternative to opioid analgesics [7]. Its effects on bone metabolism and healing have, however, not been fully elucidated, and concern has been expressed about its potential effect. The present study was designed to investigate the effects of short-term administration of ketoralac tromethamine on bone healing under stable and unstable conditions in rats, as compared to indomethacin.