Indomethacin and Celecoxib Impair Rotator Cuff Tendon-to-Bone Healing

BackgroundNonsteroidal anti-inflammatory drugs are commonly prescribed after rotator cuff repair. These agents can impair bone formation, but no studies have evaluated their impact on tendon-to-bone healing.HypothesisTraditional nonselective nonsteroidal anti-inflammatory drugs and cyclooxygenase-2–specific nonsteroidal antiinflammatory drugs interfere with tendon-to-bone healing.Study DesignControlled laboratory study.MethodsOne hundred eighty Sprague-Dawley rats underwent acute rotator cuff repairs. Postoperatively, 60 rats received 14 days of celecoxib, a cyclooxygenase-2–specific nonsteroidal anti-inflammatory drug; 60 received indomethacin, a traditional nonselective nonsteroidal anti-inflammatory drug; and 60 received standard rat chow. Animals were sacrificed at 2, 4, and 8 weeks and evaluated by gross inspection, biomechanical testing, histologic analysis, and polarized light microscopy to quantify collagen formation and maturation.ResultsFive tendons completely failed to heal (4 celecoxib, 1 indo...