Celecoxib in combination with foot and ankle orthoses for the treatment of acute ankle injuries: A study on the correlation between anti-inflammatory and analgesic mechanisms and functional recovery

Background: Celecoxib combined with an ankle orthosis is widely used in the treatment of acute ankle injuries. However, details of local adverse reactions such as skin lesions and tenderness related to the orthosis are unclear and the safety differences among different intervention groups are not well understood, affecting the choice of treatment regimen. Objective: This study aimed to explore the anti-inflammatory and analgesic mechanism of celecoxib combined with an ankle orthosis in the treatment of acute ankle injuries and its correlation with functional recovery. Method: 160 patients with moderate acute ankle injuries were randomly divided into four groups (n=40 each): the control group received routine treatment, the celecoxib group received celecoxib in addition, the orthosis group received an ankle orthosis in addition and the synergistic treatment group received both treatments. Inflammatory markers (C-reactive protein (CRP), interleukin-6(IL-6), etc.), pain markers (Visual Analogue Scale (VAS) score, etc.) and functional markers (American Academy of Foot and Ankle Surgery (AOFAS) score, etc.) were compared among the four groups. Correlation and influencing factors were analyzed and stratified analysis was performed based on the side of injury. Results: The synergistic treatment group showed better results than the other three groups in terms of inflammation, pain and functional indicators at all time points (p<0.05); the degree of inflammation and pain relief was significantly positively correlated with functional recovery (r=0.71~0.83, p<0.001); celecoxib dosage, orthotic wear and the degree of IL-6 reduction were independent influencing factors for functional recovery (p<0.05); patients with left-sided injuries benefited more significantly from synergistic treatment (p<0.05). There was no difference in the incidence of adverse reactions among the four groups (p>0.05). Conclusion: The synergistic treatment enhances efficacy through anti-inflammatory and biomechanical stabilization effects, with good safety profile and patients with left-sided injuries benefit more.