Celecoxib as Heterotopic Ossification Prophylaxis in Total Ankle Arthroplasty: A Retrospective Cohort Study
Bibliographic record
Abstract
Background: This study aimed to determine whether prophylactic celecoxib reduces the prevalence of radiographic heterotopic ossification (HO) following total ankle arthroplasty (TAA). Secondary aims included evaluating its effect on the severity of radiographic HO and its association with patient-reported outcome measures (PROMs). Methods: This retrospective cohort study included all patients who underwent a primary TAA between April 2019 to May 2023 at a single academic institution. The intervention group was composed of patients prescribed 4 weeks of celecoxib postoperatively and was compared to controls who received no celecoxib. Radiographs at ≥8 months were reviewed and graded using the modified Brooker classification for severity of HO. Ankle Osteoarthritis Score pain and disability, 36-Item Short Form Health Survey physical function and mental health were assessed at follow-up. Results: One hundred seventy-nine patients, 95 males (53.1%) and 84 females (46.9%), were included. The mean age was 65.8 ± 9.6 years. Ninety patients (50.3%) received celecoxib and 89 (49.7%) did not. The prevalence of HO at the time of follow-up (1.2 ± 0.4 years) was 53 (29.6%) with grade 0, 78 (43.6%) with grade 1, 21 (11.7%) with grade 2, 21 (11.7%) with grade 3, and 6 (3.4%) with grade 4. Patients who did not receive celecoxib were significantly more likely to develop HO and experience greater severity of HO, with odds ratios of 2.19 (95% CI 1.10-4.33, P < .05) and 2.51 (95% CI 1.43-4.44, P < .05), respectively. No significant differences in patient-reported outcomes were observed between groups. Conclusion: Celecoxib for 4 weeks postoperatively may reduce the risk and severity of HO after TAA without affecting patient-reported outcomes. HO prophylaxis did not have a statistically significant impact on PROMs. Celecoxib for HO prophylaxis can be considered following primary TAA while balancing the risks of side effects. Level of Evidence: Level III, (retrospective cohort study).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".