Medication Summary
The goals of pharmacotherapy are to reduce morbidity and prevent complications. A standard-dose nonsteroidal anti-inflammatory drug (NSAID) or aspirin is used for prophylaxis of heterotopic ossification for at least 3 weeks after hip arthroscopy.
NSAIDs
Class Summary
NSAIDs have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclooxygenase (COX) activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell membrane functions.
Ibuprofen (Advil, Motrin, Caldolor)
Ibuprofen is the drug of choice for patients with mild-to-moderate pain. It inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.
Naproxen (Aleve, Anaprox, Anaprox DS, Flanax Pain Relief, Mediproxen)
Naproxen is used for the relief of mild-to-moderate pain. It inhibits inflammatory reactions and pain by decreasing COX activity, which results in decreased prostaglandin synthesis.
Ketoprofen (Active-Ketoprofen)
Ketoprofen is used for relief of mild-to-moderate pain and inflammation. Small dosages are indicated initially in small patients, elderly patients, and patients with renal or liver disease. Doses higher than 75 mg do not increase the therapeutic effects. Administer high doses with caution, and closely observe the patient’s response.
Aspirin (Bayer Aspirin Extra Strength, Aspercin, Ascriptin Regular Strength, Bufferin, Durlaza)
Aspirin blocks prostaglandin synthetase action, which in turn inhibits prostaglandin synthesis and prevents the formation of platelet-aggregating thromboxane A2; it acts on the hypothalamic heat-regulating center to reduce fever.
Indomethacin (Indocin, Tivorbex)
Indomethacin is thought to be the most effective NSAID for the treatment of AS, though no scientific evidence supports this claim. It is used for relief of mild-to-moderate pain; it inhibits inflammatory reactions and pain by decreasing the activity of COX, which results in a decrease of prostaglandin synthesis.
-
Hip arthroscopy. Labral tear with adjacent chondrolabral separation and wave sign.
-
Hip arthroscopy. Drilling for anchor placement in acetabulum after acetabuloplasty.
-
Hip arthroscopy. Suture anchor in place ready for labral repair.
-
Hip arthroscopy. First anchor placed for labral repair.
-
Hip arthroscopy. Labral repair with wraparound technique.
-
Hip arthroscopy. Labral repair status post takedown and acetabuloplasty.
-
Hip arthroscopy. Cam lesion with adjacent cartilage damage.
-
Hip arthroscopy. Motorized burr recreating femoral head offset; resection of cam.
-
Hip arthroscopy. Cam resection.
-
Hip arthroscopy. Cam resection.
-
Location of lateral femoral cutaneous nerve.
-
Hip arthroscopy. Portal placement.
-
Cross-section at hip, showing locations of femoral nerve, artery, and vein. Courtesy of Wikimedia Commons.
-
Location of femoral neurovascular structures and lateral femoral cutaneous nerve in relation to acetabulum. Courtesy of Wikimedia Commons.
-
Frontal view of hip area, showing femoral vein, nerve, and artery, along with tensor fasciae latae. Courtesy of Wikimedia Commons.
