Effects Of Celecoxib On Knee Osteoarthritis Synovial Tissue Expression Of Cyclooxygenase-2

Osteoarthritis (OA) is the most common chronic joint degenerative disease in western countries,affecting over70%of adults from55to70years old. The prevalence of osteoarthritis increased with age, OA not only causes pain but also account for physical disability in elder people, impairing quality of life in most patients.For patients with severe osteoarthritis, Total Knee Arthroplasty (TKA) is the most effcetive way to improve the fuction of the knee joints.Celecoxib is the most common NSAIDs in the OA’s treatment of pain and inflammation. A recent study showed that celecoxib,used for three months before TKA, effectively reduced COX-2activity and synthesis and PEG2production in synovium. Because the postoperative severe pain is directly related to the PGE2concentration in the synovial fluid, celecoxib plays an essential role in the perioperative pain treatment. Preemptive Analgesia was recognized in the1990’s, the main hypothesis is the application of opium or NSAIDs before surgery can alleviate pain in postoperative patients and reduce the consumption of painkillers. Its main mechanism is divided into central analgesia and peripheral analgesia. In recent years the usage of celecoxib in preemptive analgesia was recongnized gradually. Several studies show that using celecoxib during preoperative period can effectively reduce the patients’pain score and morphine consumption, improve the ROM in the first three days after the sugery and speed up the recovery of joint function.Objects Evaluate the effect of using celecoxib before TKA on the COX-2expression in the synovium of the severe osteoarthritis and explore the mechanism of celecoxib in the preemptive analgesia.Methods42patients with severe knee osteoarthritis for TKA were allocated into the experimental group and the control group randomly.ln the experimental group/the patients use celecoxib with200mg qd for3-10days, but not in the control group. After the TKA, COX-2&mPGEs mRNA expression and protein concentration in the synovium, the concentration of PGE2, IL-1p, TNFa and PGE2concentrations in serum were measured by real-time PCR,westernblot and ELISA.Results Celecoxib, preoperative used for3-10days, reduced COX-2mRNA expression in synovium significantly (P<0.05), but not to mPGEs mRNA expression. COX-2, mPGEs protein expression, the concentrationin of PGE2, IL-1(3, TNFa and PGE2concentrations in serum have no significant difference between the two groups. Conclusion Preoperative short application of celecoxib reduced COX-2mRNA expression, but no effects on COX-2protein and downstream products.