T Nation

Celebrex

First, let me give a brief history before I ask my question. I had total knee reconstructive surgery 16 years ago. I have no remaining ACL (a graft of my hamstring was taken in order to stabilize my knee, didn’t work). Today, I am facing a surgery to replace my ACL with that of a cadaver and also implant/replace cartilage. As with any surgery, comes the rehab process. X-rays showed a large amount of arthritis in my knee joint (way more that a 33 year old should have). I recieved a 12 day supply of Celebrex (200mg 1time per day as needed??Whatever the hell as needed means). Anyway, today after taking my first dose, I feel a hell of a lot better pain wise. Does anyone else out there take Celebrex? If so, what time of the day and with or without food, etc. Also, I really do not want to have the surgery. Any other ideas or thoughts on that.

Brian, sorry to hear about your knee man that bites! What happened to your knee originally to get it to this point? I have taken Celebrex in the past when I messed up my shoulder. To be honest, I couldn’t tell any real difference in the way my shoulder felt. My Dr. told me to take it once a day with food, didn’t matter what time of day. I understand your not wanting to have another surgery. All I can tell you is that because this sounds like a pretty radical procedure, (maybe a set of procedures),I think I would get a second opinion and do lots of internet reearch on this type of surgery before I agreed to it. I hope this helps you in some way. Good luck to you!

I originally tore it up (ACL,MCL,and cartilage)in '86 playing football. long story short, got cut blocked at my MLB position. I have since posted a 500 pound squat (a while back/two years) but the pain after is still severe.

Hey BrianS, be sure to take the Celebrex with some food and water to reduce the chance of stomach bleeding. Trust me, that sucks. I was in the hospital for 5 days with six bleeding lesions in my stomach lining. Granted, it was from ibuprofen, but the risk does still exist with Celebrex. Good luck on the knee!

Celebrex is, as you may already know, a selective Cox-2 inhibitor. In essence, it provides the positive anti-inflammatory effects of other Cox inhibitors, like ibuprofen, without the negative effects associated with the non-selective drugs like possible gastric ulcers, etc. Celebrex should be taken on a SCHEDULED regimine however, not AS NEEDED. You should take it the same time of day, each day for the anti-inflammaotry effects you desire. Also, although developed as a once per day (QD) medication initially, it has been born out in real life that the half life is a bit shorter than first thought, and thus a twice daily schedule is much more effective. You should take it 200mg twice a day every day. Good luck with your surgery!

Hi Poman. Actually, if you go to the FDA website and look up Celebrex, they state that it can cause stomach bleeding. Not trying to be argumentative, but just don’t want to see someone go through what I went through. No fun, and stomach bleeding can be insidious in that I had no warning at all (no burning, indigestion, upset stomach, etc.) until general fatigue hit me one day, I had a black stool that evening, and then vomited bright red blood the next morning. Then straight into the hospital.

Hey, sorry about your knee. About the surgery though usually the graft of your hamstring is done (this takes the place of your MCL) to get the knee correctly aligned for the ACL surgery. I would recommend having the ACL done especially if it is a cadaver, this is alot easier to recover from. The only time that you may be able to get away without an ACL is when your other ligaments are strong enough to support your knee without it, obviously this is not your case. I had both of these surgeries myself, only I had an LCL instead of MCL. I can do pretty much everything without a brace now as well, except for soccer of course. Work your hamstring GOOD! As far as supplements go I accually found that Cetyl-Myristoliate works wonders for me but everyone is different.

Well, there will always be a chance for stomach ulcers when taking any COX inhibiting drug. But Celebrex (and Vioxx, Bextra and the other Cox-2’s) were specifically designed in part to alleviate the problems that inherantly come from Cox 1 and 2 nonspecific drugs, such as Ibuprofen and Naprosyn. Basically, any drug which binds to the Cox 1 receptor will stop the Cox enzyme from shutting off the production of stomach acid when it needs to, thus leading to the ulcer problem. Celebrex, being Cox-2 selective, does not preferentially bind to Cox-1, as does ibuprofen, but it DOES bind to a limited degree. Hence it is SELECTIVE and not specific for the Cox-2 receptor. It could be a problem for people who take a lot of Celebrex (800-1000 mg/day) but for a normal dosage, I have never seen anyone come down with it in my practice setting. To be sure though, you should take Celebrex with food, like the other NSAIDS to blunt any Cox-1 effects it may have.

I have be in the ACL "industry"since 79 personally and professionally in Alpine skiing so I understand your position. Regarding surgery if you have no ACL left at all, 3 choices are available cadaver, patella and hamstring. Patella is rock solid, but normal tendenitis for 1 year, but the most solid repair, hamstring is a faster rehab and most common for sports where the hips normally do not fall below knee level, in other words if your sport does not require massive quad strength such as Alpine skiing where extreeme forces are involved, you can consider the hamstring as a strong option.As far as no surgery, that is risky at best. This is because when there is no ACL the cartalige is predisposed to more shearing forces this is also why the early onset of arthritis is setting in. stabalize and save the joint as best as possible with a full spectrum rehab program far beyond what your insurance covers. The VMO and hamstring are your key players in providing the repair procedure with stability.
If you are going to go for max healing use the QRS unit Electra magnetic pulse therapy, hyperbaric chamber and you could easily qualify for GH from even your own Doc plus a full spectrum of supps for your blood work.
By having a proper procedure done now, you will have the chance to play hard well into later life, without it, you only increase your on set of arthritis and also are at far more risk for a severe cartilage injury.
contact Dr Richard Steadman for patella and Dr Hawkins for hamstring both out of Vail Colorado.Check the web for more info

I really appreciate the replies I have recieved. I will surely use this info to help me in my decision. I have an MRI scheduled for Jan 30 and will know more then about what it is exactly that I will be doing. Again Thanks, like true T-men, you shined when another one of yours needed it.

I’ve had 2 acl reconstructions in the same knee(now have a cadaver ACL graft) and 30% removal of my medial meniscus…ahhh i love waking up and feeling that wonderful stiffness.

Anyway, I’m only 24 and tendonitis is already goin on down there…is GH even a feasible option? I don’t know how well my knee doc would take that(his name is Preston Wolin in Chicago), being I’m somewhat young to go on GH.

Any things I should bring up for GH therapy? Or even Deca? i just ask b/c I always hear how good Deca is in terms of lubing up the joints.

I gotta say, Poman, your technical expertise in this area is very impressive!

Hey! sorry to hear about the knee my friend. From a chicks point I tore my ACL over two years ago. However; the doc’s are against doing surgery to repair it, my leg has fully compensated for it. I was never able to return to Gymnastics again,it just wouldn’t hold out long enough. I have re-occuring tendinitis and have never been able to squat proberly without it really playing up! Any advice for me T-MEN and T- VIXENS… Thanx

Ciao Anna.


Like all the others who answered, I had ACL surgery as well. It was from hamstring, and now my right leg is 20% smaller than the left one, not to mention the strenght. When I do 1 leg squat (following Ian King advices), I experiment a real strong and embarassing shake in my right leg, so that I must hold on to something, while with the left one I can complete a full single leg squat (bodyweight only). What I can tell you now, from a BB point of view, is to switch to unilateral movement. Unfortunately, this switch may last for all your future career, sorry. Then, warm-up very very much on a cyclette, not walking or stepping: this prepare the right temperature in your fluids and to me it avoids the always-present pain that I have at the beginning of leg day. I believe that the problem lies in the lenght of the rebuilt ligament. Since it’s a different tissue thatn the one it has replaced, it doesn’t have the same mechanical charateristics (it wasn’t meant to be there!). My personal opinion is that surgeons go for a thighter but safer lenght (thus the reason why it is always hard to completely bend the leg). Don’t even forget the miracle of ice. I know it is not always possible to put it on the knee just after the work-out, but I think it works pretty well if you do that the same evening.


I also have a full complete article that I’ve found one year ago surfing through the most serious web-sites about training. It’s called “WOMEN’S ATHLETICS AND KNEE INJURY PREVENTION”.

For Dan and Anna


Dan


In my experience the net result post op, is 50% procedure 50% rehab. Before considering using Gh you need to know how long ago your procedure was done.Let’s just say for example you have a ACL that is 2 years old from a cadaver and it has stretched or even torn 30% ,using GH is not going to make it shorten or grow, however there is a fairly simple ACL procedure called thermal shrinkage that is way faster than a full repair for rehab,if this was performed then you could consider Gh as an accelorater for healing and increasing the tensil strength. Taking “anything” without a full MRI and or procedure is just shooting in the dark and also just masking the bodies warning signs that something is wrong. Make the investment of getting things taken care of now and enjoy the results later otherwise it sounds like you will be taking a lot more than 600mg of Ibu and putting your joint at even more risk not mention the hassle.

Anna,


These days ACL prodecdures can be done long after the injury as it sounds is the case for you.

Step one choose the Doc
step two choose the procedure
Step three perform 4-5 weeks of pre op strength training especially the ham and VMO
step four get the prodcedure done
step five rehab with a qualified pt and strength coach.

When choosing the Doc just look how many procedures of your choice he does a year, who and what are the results, the exact samething goes for the Rehab team, don’t accept unqualified advice or counsel. Do your home work otherwise you may end up being a victim of just giving someone experience and a large chunk of cash. These are your knees and as such you need to understand that with age things break down no matter how healthy or how much “juice” is added, so go to great lengths now to insure a long an full scale play life.

For both Dan and Anna, six to nine months invested now in your ACL’s could easily extend your full scale play life 20 years Unless you guys are headed for the Super Bowl or a shot at winning a World title in your respective sports and this is the last chance for your Pro claim to fame, be as wise as the pro’s and think long term.

Thanks mammann! That means alot coming from a t-man. I have extremely good professors in my therapeutics classes here at Mercer Pharmacy school, so they really deserve all the credit :o).

Hello all! Thank you so very much for the advice! I shall follow up on what’s been advised. Keep you posted!