The effects of COX-2 anti-inflammatory drugs on soft tissue healing: a review of the literature

COX-2 specific inhibitors (coxibs) have become a popular treatment for musculoskeletal disorders given that the incidence of gastrointestinal side effects is lower with these drugs than with traditional non-steroidal anti-inflammatory drugs. The aim of this review is to discuss the results of animal studies investigating the role of coxibs in the healing of soft tissues. MEDLINE was searched (years 2001-2009) for studies analyzing the effect of coxibs on the healing of soft tissues. There are relatively few data in the literature suggesting that coxibs can impair soft tissue healing and the data existing have the limitation of having been generated in animal studies. In fact, the method of administration and the doses used make it difficult to translate these results to the clinical setting. Short-term use of coxibs following lesions to ligaments or tendons remains a prudent choice. Traditional anti-inflammatory drugs are a safer treatment for patients with a high cardiovascular risk. These drugs should, however, be evaluated carefully with regards to gastrointestinal events and their still poorly defined effect on tissue healing.