
The systematic review and meta-analysis evaluated 665 patients across randomized controlled trials to assess the efficacy of indomethacin in preventing heterotopic ossification (HO). Results showed that indomethacin significantly reduced the incidence of grade I-II HO compared to those not receiving the drug but had no significant effect on higher-grade HO (III-IV). Gastrointestinal side effects were more common in the indomethacin group, and although bone nonunion was observed more frequently in these patients, it was not statistically significant. The findings suggest that while indomethacin is beneficial for lower-grade HO prevention, its use is associated with gastrointestinal risks, warranting caution in clinical practice. Further randomized studies are needed to validate these results.
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