Studies - Common painkillers might delay bone healing

WASHINGTON -- Broke your leg? Some doctors are warning to carefully consider which painkiller you use.

New research suggests some of the most widely used painkillers may delay healing of a broken bone -- and one study, albeit in animals, that's getting lots of doctors' attention suggests the blockbuster sellers Vioxx and Celebrex are among the culprits.

There's no proof yet that anti-inflammatory painkillers cause major bone problems, and the makers of Vioxx and Celebrex deny any link.

But some bone experts call the research compelling enough that doctors should explain the risk before patients choose a painkiller for a broken bone, spinal surgery or other bone injury.

"It's time to tell the public," concludes Dr. Thomas Einhorn, Boston University's orthopedic surgery chairman -- who says he'd choose a mild narcotic over more common painkillers if he broke a leg.

It's an important question, as more Americans regularly use Vioxx, Celebrex and other anti-inflammatory painkillers called NSAIDS that also are implicated. Doctors increasingly offer bone surgery or fracture patients higherdoses of such painkillers in place of narcotics.

At issue is the discovery that an enzyme called cox-2, which causes pain and inflammation, also appears to play a crucial role in bone healing.

Vioxx and Celebrex fight pain by blocking cox-2.

Researchers at the University of Medicine and Dentistry of New Jersey gave 253 young rats with a splinted broken leg either Vioxx, Celebrex, indomethacin or no drug.

Indomethacin-treated rats took a week longer to heal than untreated rats; the resulting bone was as strong.

But rats given Vioxx or Celebrex hadn't fully healed after two months -- and what new bone formed sometimes was only a weakened shell.