Heterotopic Ossification: A Challenging Complication of Total Hip Arthroplasty: Risk Factors, Diagnosis, Prophylaxis, and Treatment
Background. This review is intended to summarize the risk factors, classification, diagnosis, and treatment of heterotopic ossification (HO) of previously published studies. Results. Heterotopic ossification is a common complication of total hip arthroplasty. Its prevalence is not the same in all of...
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doaj-9e101c625ce64fdbbbf0d3c154d895042020-11-25T02:12:17ZengHindawi LimitedBioMed Research International2314-61332314-61412019-01-01201910.1155/2019/38601423860142Heterotopic Ossification: A Challenging Complication of Total Hip Arthroplasty: Risk Factors, Diagnosis, Prophylaxis, and TreatmentPaweł Łęgosz0Maciej Otworowski1Aleksandra Sibilska2Krzysztof Starszak3Daniel Kotrych4Adam Kwapisz5Marek Synder6Department of Orthopaedics and Traumatology of the Musculoskeletal System, Infant Jesus Teaching Hospital, Medical University of Warsaw, Warsaw, PolandDepartment of Orthopaedics and Traumatology of the Musculoskeletal System, Infant Jesus Teaching Hospital, Medical University of Warsaw, Warsaw, PolandClinic of Orthopaedics and Paediatric Orthopaedics Medical University of Lodz, Lodz, PolandDepartment of Orthopaedics and Traumatology of the Musculoskeletal System, Infant Jesus Teaching Hospital, Medical University of Warsaw, Warsaw, PolandDepartment of Orthopaedics, Traumatology and Orthopaedic Oncology, Pomeranian Medical University of Szczecin, Pomeranian Medical Academy Oncology Therapy and Research Center, Szczecin, PolandClinic of Orthopaedics and Paediatric Orthopaedics Medical University of Lodz, Lodz, PolandClinic of Orthopaedics and Paediatric Orthopaedics Medical University of Lodz, Lodz, PolandBackground. This review is intended to summarize the risk factors, classification, diagnosis, and treatment of heterotopic ossification (HO) of previously published studies. Results. Heterotopic ossification is a common complication of total hip arthroplasty. Its prevalence is not the same in all of the patient groups. Frequency of HO varies from 15 to 90%. Hip ankylosis, male gender, and previous history of HO are said to be risk factors with a significant level. Diagnosis is based on a single AP radiograph: the Brooker classification that divides HO into four grades is the most commonly used. The confirmation test that can be used is a bone scan. A great amount of bone metabolic turnover markers have been tested, but none of them seems to be relevant in case of prevention or diagnosis of HO. The most effective prophylactic treatment is radiotherapy or administration of nonsteroidal anti-inflammatory drugs. Over the years a lot of different RT protocols have been tested. Nowadays the most often used regimen is 7 Gy given postoperatively in a single dose. The most commonly prescribed drug in prophylaxis of HO is indomethacin. Also, the efficacy of ibuprofen and diclofenac was proven. Recently researchers focused on selective COX-2 inhibitors. They appear to be as effective as nonselective NSAIDs having less side effects. The one and only treatment of HO is a revision arthroplasty.http://dx.doi.org/10.1155/2019/3860142 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Paweł Łęgosz Maciej Otworowski Aleksandra Sibilska Krzysztof Starszak Daniel Kotrych Adam Kwapisz Marek Synder |
spellingShingle |
Paweł Łęgosz Maciej Otworowski Aleksandra Sibilska Krzysztof Starszak Daniel Kotrych Adam Kwapisz Marek Synder Heterotopic Ossification: A Challenging Complication of Total Hip Arthroplasty: Risk Factors, Diagnosis, Prophylaxis, and Treatment BioMed Research International |
author_facet |
Paweł Łęgosz Maciej Otworowski Aleksandra Sibilska Krzysztof Starszak Daniel Kotrych Adam Kwapisz Marek Synder |
author_sort |
Paweł Łęgosz |
title |
Heterotopic Ossification: A Challenging Complication of Total Hip Arthroplasty: Risk Factors, Diagnosis, Prophylaxis, and Treatment |
title_short |
Heterotopic Ossification: A Challenging Complication of Total Hip Arthroplasty: Risk Factors, Diagnosis, Prophylaxis, and Treatment |
title_full |
Heterotopic Ossification: A Challenging Complication of Total Hip Arthroplasty: Risk Factors, Diagnosis, Prophylaxis, and Treatment |
title_fullStr |
Heterotopic Ossification: A Challenging Complication of Total Hip Arthroplasty: Risk Factors, Diagnosis, Prophylaxis, and Treatment |
title_full_unstemmed |
Heterotopic Ossification: A Challenging Complication of Total Hip Arthroplasty: Risk Factors, Diagnosis, Prophylaxis, and Treatment |
title_sort |
heterotopic ossification: a challenging complication of total hip arthroplasty: risk factors, diagnosis, prophylaxis, and treatment |
publisher |
Hindawi Limited |
series |
BioMed Research International |
issn |
2314-6133 2314-6141 |
publishDate |
2019-01-01 |
description |
Background. This review is intended to summarize the risk factors, classification, diagnosis, and treatment of heterotopic ossification (HO) of previously published studies. Results. Heterotopic ossification is a common complication of total hip arthroplasty. Its prevalence is not the same in all of the patient groups. Frequency of HO varies from 15 to 90%. Hip ankylosis, male gender, and previous history of HO are said to be risk factors with a significant level. Diagnosis is based on a single AP radiograph: the Brooker classification that divides HO into four grades is the most commonly used. The confirmation test that can be used is a bone scan. A great amount of bone metabolic turnover markers have been tested, but none of them seems to be relevant in case of prevention or diagnosis of HO. The most effective prophylactic treatment is radiotherapy or administration of nonsteroidal anti-inflammatory drugs. Over the years a lot of different RT protocols have been tested. Nowadays the most often used regimen is 7 Gy given postoperatively in a single dose. The most commonly prescribed drug in prophylaxis of HO is indomethacin. Also, the efficacy of ibuprofen and diclofenac was proven. Recently researchers focused on selective COX-2 inhibitors. They appear to be as effective as nonselective NSAIDs having less side effects. The one and only treatment of HO is a revision arthroplasty. |
url |
http://dx.doi.org/10.1155/2019/3860142 |
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