Prevention of heterotopic ossification in high-risk patients with total hip arthroplasty: the experience of a combined therapeutic protocol

被引：0
作者：
Emilios E. Pakos
Evita J. Pitouli
Pericles G. Tsekeris
Vasiliki Papathanasopoulou
Kosmas Stafilas
Theodore H. Xenakis
机构：
[1] University Hospital of Ioannina,Department of Orthopaedic Surgery
[2] University of Ioannina,Department of Radiation Therapy
[3] School of Medicine,undefined
[4] University Hospital of Ioannina,undefined
[5] University of Ioannina,undefined
[6] School of Medicine,undefined
来源：
International Orthopaedics | 2006年 / 30卷
关键词：
Indomethacin; Heterotopic Ossification; Radiographic Evidence; Acetabular Fracture; Diffuse Idiopathic Skeletal Hyperostosis;
D O I：
暂无
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学科分类号：
摘要：
The combination of radiotherapy and indomethacin for the prevention of heterotopic ossification (HO) in high-risk patients undergoing total hip arthroplasty (THA) has not been reported. The aim of the present study was to present the experience of our department with this combined therapeutic protocol. Fifty-four patients who underwent THA received a single dose of 7 Gy of postoperative radiotherapy and 75 mg of indomethacin for 15 days. Patients were analyzed for clinical and radiographical evidence of HO development at 1 year postoperatively. The overall radiographical incidence of HO was 20.4% (95% CI 10.6–33.5%), while only 1 patient with clinically significant HO was seen. Patients with secondary arthritis due to congenital hip disease had a statistically significantly higher incidence of HO compared with those with osteoarthrosis. The clinical assessment with the Merle d’Aubigné score showed that patients with radiographic documentation of HO had a lower mean score compared with those with no evidence of HO. No treatment-related side effects were seen. Combined radiotherapy and indomethacin was effective in preventing heterotopic ossification after total hip arthroplasty. The evaluation of this efficacy compared with radiotherapy or NSAIDs alone should be the future target of larger randomized designs.
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页码：79 / 83
页数：4
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  • [1] Anthony P(1987)Prevention of heterotopic bone formation with early post operative irradiation in high risk patients undergoing total hip arthroplasty: comparison of 10.00 Gy vs 20.00 Gy schedules Int J Radiat Oncol Biol Phys 13 365-369
  • [2] Keys H(1973)Ectopic ossification following total hip replacement. Incidence and a method of classification J Bone Joint Surg Am 55 1629-1632
  • [3] Evarts CM(2001)Risk factors for heterotopic ossification in total hip arthroplasty Arch Orthop Trauma Surg 121 531-535
  • [4] Rubin P(2004)Non-steroidal anti-inflammatory drugs for preventing heterotopic bone formation after hip arthroplasty Cochrane Database Syst Rev 3 CD001160-62
  • [5] Lush C(1994)Randomized trial comparing preoperative versus postoperative irradiation for prevention of heterotopic ossification following prosthetic total hip replacement: preliminary results Int J Radiat Oncol Biol Phys 30 55-466
  • [6] Brooker AF(1999)Utility of radiation in the prevention of heterotopic ossification following repair of traumatic acetabular fracture Int J Radiat Oncol Biol Phys 45 461-485
  • [7] Bowerman JW(2004)Dose-dependent efficacy of diclofenac-cholestyramine on pain and periarticular ossifications after total hip arthroplasty: a double-blind, prospective, randomised trial Arch Orthop Trauma Surg 124 483-595
  • [8] Robinson RA(1995)Single-dose irradiation for the prevention of heterotopic ossification after total hip arthroplasty. A comparison of doses of five hundred and fifty and seven hundred centigray J Bone Joint Surg Am 77 590-416
  • [9] Riley LH(2002)Heterotopic ossification after hip and knee arthroplasty: risk factors, prevention, and treatment J Am Acad Orthop Surg 10 409-602
  • [10] Eggli S(1997)Prevention of heterotopic ossification after total hip replacement. A prospective, randomised study using acetylsalicylic acid, indomethacin and fractional or single-dose irradiation J Bone Joint Surg Br 79 596-773
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