South West Orthopaedic Club Abstracts of Meeting in Exeter, November 1984

Acetabular destruction can significantly increase the difficulty of performing hip replacement and is, therefore, a much more important consideration than femoral head necrosis. In this study acetabular migration was used as a measure of acetabular destruction. Fifty-eight patients undergoing total hip replacement at the Princess Elizabeth Orthopaedic Hospital for primary osteoarthritis were studied. Thirty-six patients undergoing 38 hip replacements had adequate sequential X-rays and drug history available. Twenty-three hips showed significant acetabular migration and all but one of these hips were in patients taking regular NSAID. Of the 15 hips not showing migration only 3 were in patients taking regular NSAID. The two groups of patients did not differ significantly in age, sex or femoral valgus angles. Thus, a significant correlation between regular ingestion of NSAID and acetabular bone destruction was found. This finding adds evidence to the association of NSAID with impaired bone remodelling and suggests that their use may be harmful, both before and after hip replacement.