Comprehensive review of the impact of NSAIDs on bone healing outcomes in animal models: conflicting evidence and methodological considerations

This review presents a comprehensive review of the literature regarding the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on bone healing outcomes in animal models. A thorough search was conducted using PubMed, Web of Science, and Google Scholar, resulting in the inclusion of 27 papers that met the predetermined criteria. The majority of the studies utilized rodent and rabbit models, with limited research conducted on dogs and no studies on other animal species. The findings from the included studies presented conflicting evidence on the impact of NSAIDs on bone healing, with some reporting negative effects such as delayed healing and impaired bone formation. Interestingly, no consistent relationship was found between the type, potency, dosage, or timing of NSAID administration and the observed effects. Various methodological limitations were identified in the reviewed studies, including small sample sizes, lack of diverse animal populations, and inadequate statistical analyses. It is important to address these limitations and conduct further research, particularly involving companion and farm animals, to improve the clinical relevance of the findings. Caution should be exercised when using NSAIDs in the management of bone fractures, and a more comprehensive understanding of their effects on bone healing is needed to optimize treatment strategies.