I find it refreshing to find someone admitting when there is no unarguable answer. I became a Physicians Assistant in 1980, had my own first significant orthopedic surgery (total knee replacement) two weeks ago, and notice from then to now it was and is possible to find those who say NSAIDs harm, don’t affect, or help healing post op. Since there is no consensus, I prefer to not wishfully believe there is. I’m taking naproxyn 440 mg twice a day. It’s a dose I have taken occasionally in the past for sprains and strains, with no ill impacts other than easy bruising. Is it reducing my swelling and pain? Maybe. Swelling and pain are going down. John Laudenslager
A number of arguments counted against the COX-3 hypothesis: COX-2-selective inhibitors react weakly with the COX-3 enzymatic site, because the site is identical to that in COX-1, but they are as good at reducing fever as older NSAIDs. The fever response has also been clearly associated with a rapid induction of COX-2 expression and an associated increase in prostaglandin E2 production, with no role for COX-1 or a COX-1 gene product (., COX-3). Finally, the sites of COX-3 expression do not appear to fit in well with those sites associated with fever, and the protein should be present within the hypothalamus rather than the cerebral cortex . All these considerations appeared to argue against COX-3 being the site of the antipyretic actions of NSAIDs and COX-2-selective agents. However, the results could be read as showing that paracetamol acts at a different site than the other NSAIDs and that more than one COX isoform contribute to the fever response.