Objectives The purpose of this study was to systematically review the available evidence
regarding any plausible deleterious effects of nonsteroidal anti-inflammatory drugs
(NSAIDs) on chondrocytes, chondrocyte differentiation, and allograft or autograft
incorporation after cartilage repair procedures. Design Three databases (PubMed, Science
Direct, and Cochrane Library) were screened for eligible studies: investigating the
effects of NSAIDs on chondrocytes, chondrogenic differentiation, or allograft/autograft
incorporation. This evaluation included studies of any level of evidence, written
in English, reporting clinical or preclinical results, published in peer review journals
and dealing with our topic. All articles evaluating the effects of NSAIDs on either
osteoarthritic (OA) chondrocyte samples or OA chondrocyte models were excluded. Moreover,
articles about bone healing in which allograft or autograft incorporation was not
investigated were also excluded. Methodologic quality assessment was performed for
in vivo animal studies according to ARRIVE guidelines, and risk of bias of each included
study was identified using the ROBINS-I tool. Results Eighteen studies were included
in the review: 4 in vitro studies, 13 animal studies, and 1 human study. According
to these studies NSAIDs have no detrimental effect on healthy mature chondrocytes;
however, these drugs influence chondrocyte differentiation and graft incorporation
and therefore may interfere with chondrogenesis and incorporation after transplantation
of chondrocytes or osteochondral grafts. Conclusion The use of NSAIDs, systemic or
local, after cartilage repair procedures should be avoided unless a substantial clinical
benefit would otherwise be withheld from the patient. More human studies are needed
to analyze the effect of NSAIDs on cartilage repair.
