Heterotopic ossification after total hip arthroplasty: When is development completed?

Tytuł:: Heterotopic ossification after total hip arthroplasty: When is development completed?
Autorzy:: Willburger RE; Department of Orthopaedic Surgery, Martin-Luther-Krankenhaus, Voedestrasse 79, 44866, Bochum, Germany.
Brinkhoff F; Department of Orthopaedic Surgery, Martin-Luther-Krankenhaus, Voedestrasse 79, 44866, Bochum, Germany.
Nottenkämper J; Department of Orthopaedic Surgery, Martin-Luther-Krankenhaus, Voedestrasse 79, 44866, Bochum, Germany.
Krapp J; Department of Orthopaedic Surgery, Martin-Luther-Krankenhaus, Voedestrasse 79, 44866, Bochum, Germany.
Oberberg S; Department of Orthopaedic Surgery, Martin-Luther-Krankenhaus, Voedestrasse 79, 44866, Bochum, Germany. .
Źródło:: Journal of orthopaedic surgery and research [J Orthop Surg Res] 2022 Mar 05; Vol. 17 (1), pp. 147. Date of Electronic Publication: 2022 Mar 05.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: London : BioMed Central, 2006-
MeSH Terms:: Arthroplasty, Replacement, Hip*/adverse effects
Postoperative Complications*/diagnostic imaging
Postoperative Complications*/etiology
Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage
Cyclooxygenase 2 Inhibitors/*administration & dosage
Etoricoxib/*administration & dosage
Ossification, Heterotopic/*prevention & control
Aged ; Female ; Humans ; Male ; Middle Aged ; Ossification, Heterotopic/complications ; Ossification, Heterotopic/diagnostic imaging ; Prospective Studies
References:: Zhu Y, Zhang F, Chen W, Zhang Q, Liu S, Zhang Y. Incidence and risk factors for heterotopic ossification after total hip arthroplasty: a meta-analysis. Arch Orthop Trauma Surg. 2015;135:1307–14. (PMID: 10.1007/s00402-015-2277-8)
Eggli S, Woo A. Risk factors for heterotopic ossification in total hip arthroplasty. Arch Orthop Trauma Surg. 2001;121:531–5. (PMID: 10.1007/s004020100287)
Legosz P, Otworowski M, Sibilska A, Starszak K, Kotrych D, Kwapisz A, Synder M. Heterotopic ossification: a challenging complication of total hip arthroplasty: risk factors, diagnosis, prophylaxis, and treatment. Biomed Res Int. 2019;2019:1–8. (PMID: 10.1155/2019/3860142)
Rüdiger HA, Dittrich M, Robinson J, Mansour T, Schwab T, Stadelmann VA, Leunig M. The impact of heterotopic ossification on self-reported outcomes after total hip arthroplasty using the direct anterior approach. J Bone Jt Surg Am. 2020;102(Suppl 2):91–8. (PMID: 10.2106/JBJS.20.00071)
Van Erp JHJ, Massier JRA, Truijen S, Bekkers JEJ, Snijders TE, de Gast A. Heterotopic ossification in primary total hip arthroplasty using the posterolateral compared to the direct lateral approach. Arch Orthop Trauma Surg. 2021. https://doi.org/10.1007/s00402-021-03783-6 . (PMID: 10.1007/s00402-021-03783-6341010179110501)
Alijanipour P, Patel RP, Naik TU, Parvizi J. Heterotopic ossification in primary total hip arthroplasty using the direct anterior versus direct lateral approach. J Arthroplasty. 2017;32:1323–7. (PMID: 10.1016/j.arth.2016.11.030)
Eggli S, Rodriguez J, Ganz R. Heterotopic ossification in total hip arthroplasty: the significance for clinical outcome. Acta Orthop Belg. 2000;66:174–80. (PMID: 10842879)
Ahrengart L. Periarticular heterotopic ossification after total hip arthroplasty. Risk factors and consequences. Clin Orthop Rel Res. 1991;263:49–58. (PMID: 10.1097/00003086-199102000-00005)
Cai L, Wang Z, Luo X, She W, Zhang H. Optimal strategies for the prevention of heterotopic ossification after total hip arthroplasty: a network meta-analysis. Int J Surg. 2019;62:74–85. (PMID: 10.1016/j.ijsu.2018.12.011)
Migliorini F, Trivellas A, Eschweiler J, Driessen A, Tingart M, Maffulli N. NSAIDs for prophylaxis for heterotopic ossification after total hip arthroplasty: a Bayesian network meta-analysis. Calc Tissue Int. 2021;108:196–206. (PMID: 10.1007/s00223-020-00763-7)
Brooker AF, Bowerman JW, Robinson RA, Riley LH. Ectopic ossification following total hip replacement. Incidence and method of classification. J Bone Jt Surg Am. 1973;55:1629–32. (PMID: 10.2106/00004623-197355080-00006)
Winkler S, Springorum HR, Vaitl T, Handel M, Barta S, Kehl V, Craiovan B, Grifka J. Comparative clinical study of the prophylaxis of heterotopic ossifications after total hip arthroplasty using etoricoxib or diclofenac. Int Orthop. 2016;40:673–80. (PMID: 10.1007/s00264-015-3077-z)
Oberberg S, Nottenkämper N, Heukamp M, Krapp J, Willburger RE. Etoricoxib is safe and effective in preventing heterotopic ossification after primary total hip arthroplasty. J Orthop Surg Res. 2021;16:163–8. (PMID: 10.1186/s13018-021-02297-6)
Contributed Indexing:: Keywords: Brooker; Heterotopic ossification; Ossification prophylaxis; Total hip arthroplasty
Substance Nomenclature:: 0 (Anti-Inflammatory Agents, Non-Steroidal)
0 (Cyclooxygenase 2 Inhibitors)
WRX4NFY03R (Etoricoxib)
Entry Date(s):: Date Created: 20220306 Date Completed: 20220322 Latest Revision: 20220719
Update Code:: 20240105
PubMed Central ID:: PMC8898402
DOI:: 10.1186/s13018-022-02959-z
PMID:: 35248082
: Czasopismo naukowe

Pełny tekst

Background: Heterotopic ossifications (HO) are a common complication after total hip arthroplasty (THA). Nonsteroidal anti-inflammatory drugs have proven to reduce the occurrence of HO. It is still unclear when the formation of HO is finished. Aim of our study was to answer this question.
Methods: In a prospective study, the occurrence of periarticular HO was checked during the follow-up (FU) examinations. In total, 75 consecutive patients who underwent THA were included. To ensure a high follow-up rate, only patients with a life expectancy of at least 10 years were included. A medical ossification prophylaxis with mostly etoricoxib (90 mg once daily) was administered. Follow-up examinations were performed at 3 months, 1 year, 3, 5, and 10 years postoperatively. Each time, a clinical and radiological examination was carried out. The HO was graded according to Brooker's method.
Results: Low-grade HO classified by Brooker grade I and II occurred significantly more frequent than HO grade III. In patients with present HO, a possible increase in Brooker stage could further be observed within 3 years postoperatively. After 3 years, the formation of HO was completed in all patients.
Conclusion: Three years after THA, the formation of HO is complete. After more than 3 years postoperatively, if HO occurs or increases, other triggering causes such as new trauma, periarticular infection, or implant loosening should be considered.
(© 2022. The Author(s).)

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