BoneKEy Reports | BoneKEy Watch
Giving opioids after surgery may impair fracture healing
DOI:10.1038/bonekey.2013.198
An established rat fracture model was used to investigate whether morphine administration after surgery to induce a femoral fracture had a negative impact on bone healing.
A group of 50 rats was divided into two groups – both received two doses of acetaminophen immediately after surgery—then one group was given saline injections every 8 h for 4 or 8 weeks while the other received subcutaneous morphine at a dose of 5 mg/100 μl/kg. Half the animals in each group were euthanized after 4 weeks with the rest at 8 weeks, and their femurs were then subjected to a three-point biomechanical bend test. Signs of bone remodeling were detected using histology and micro-CT scans.
No difference in callus formation was observed at the 4-week point, but rats treated with morphine showed significantly reduced callus strength at eight weeks (P=0.048). The bone callus that had formed was less mature and showed less remodeling than in control rats. In the control group, callus strength in the broken femur had reached 49% of that of the contralateral bone; in the morphine-treated group, it had reached only 30%.
Editor’s comment: The finding that continuous post-operative opioid analgesia interferes with fracture healing in this model is important. However, it will be important to investigate the impact of more clinically realistic short-term use of morphine analgesia.
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