a traditional non-selective NSAID (32, 34, 36). Subsequent genetic and in vivo studies have provided strong evidence that inflam- mation stimulated by the COX-2 isoenzyme is essential for fracture healing, and that COX-2 selective NSAID have an equal or greater negative effect on fracture healing in rats than non-selective NSAID (7, 8, 21, 37–43). Thus, no single NSAID or group of NSAID has been cleared as being ‘safe’, or having no potential effect on bone healing.