Ross Hauser, MD discusses in great detail the acceleration of articular cartilage degeneration in osteoarthritis by nonsteroidal anti inflammatory drugs (NSAIDs) in Journal of Prolotherapy Vol 2:1, 2010. NSAIDs are among the most commonly prescribed drugs for the treatment of osteoarthritis symptoms and are taken by 20 to 30% of elderly people in developed countries. Because of the potential side effects on the liver, stomach, GI tract, and heart, including death, treatment guidelines advise against long term use. One of the best documented but lesser known long-term side effects of NSAIDs is their negative impact on articular cartilage.
In human studies, NSAIDs have been shown to accelerate the radiographic progression of OA of the knee and hip. Dr. Hauser postulates that the massive NSAID use in osteoarthritic patients since their introduction over the past forty years is one of the main causes of the rapid rise in the need for hip and knee replacement surgery, both now and in the future.
If NSAID use continues, then most likely the exponential rise in degenerative arthritis and subsequent musculoskeletal surgeries, including knee and hip replacements as well as spine surgeries, will continue to rise as well.
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