Randomized trial comparing early postoperative irradiation vs. the use of nonsteroidal antiinflammatory drugs for prevention of heterotopic ossification following prosthetic total hip replacement

Kölbl, Oliver; Knelles, D.; Barthel, Thomas; Kraus, U; Flentje, Michael; Eulert, J.

doi:10.1016/s0360-3016(97)00496-3

Cited by 58 publications

(35 citation statements)

References 25 publications

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“…The overall incidence of HO in our study was 18.1%, the incidence of severe HO (Brooker 3-4) 1.9%. These results are comparable to those reported by studies evaluating postoperative irradiation [26,40], especially regarding the incidence of clinically relevant, severe HO. Gregoritch et al [12] found a 28% and 4.6% incidence of overall (Brooker 1-4) and severe (Brooker 3-4) HO after postoperative single-fraction radiotherapy.…”

Section: Discussionsupporting

confidence: 88%

“…It is presumed that a protein called bone morphogenetic protein released by a local prostaglandin-inducing inflammation is responsible for the process [13,25,37,40]. In the past, two different treatment modalities were analyzed regarding their effectiveness to reduce ossification after hip surgery: the use of NSAIDs [11,18,26,34] and radiotherapy [12,15,22,26,27,41,43,45].…”

Section: Discussionmentioning

confidence: 99%

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Preoperative Irradiation for Prevention of Heterotopic Ossification Following Prosthetic Total Hip Replacement

et al. 2003

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Preoperative radiotherapy on the evening before surgery is an effective treatment modality to reduce overall (Brooker 1-4) and clinically relevant, severe HOs (Brooker 3-4), and includes several advantages compared to postoperative irradiation. Previous ipsi- and contralateral HOs were identified as high risk factors for HO in this study. In patients with these risk factors, the incidence of HO increased.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Preoperative Irradiation for Prevention of Heterotopic Ossification Following Prosthetic Total Hip Replacement

et al. 2003

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“…The effectiveness of RT for the prevention of HO after major hip procedures such as total hip arthroplasty and acetabular fractures has been extensively studied with varying results [6,8,12,14]. However, the time of RT and the dose-response effect of RT on the incidence of HO is still a matter for investigation [5,8,11,13,[21][22][23].…”

Section: Discussionmentioning

confidence: 99%

“…Several types of NSAID in different daily doses and durations of treatment have been employed with varying success in the reported outcomes [4,7,19,24]. Several randomised trials have compared the efficacy of RT and NSAIDs [12,16]. A large meta-analysis of randomised trials comparing RT with NSAIDs reported that RT is on average more effective than NSAIDs (apart from aspirin) and found a statistically significant dose-response relationship of RT with HO [17].…”

Section: Discussionmentioning

confidence: 99%

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

Pakos

Pitouli

Tsekeris

et al. 2006

International Orthopaedics (SICO

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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 this 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 analysed for clinical and radiographical evidence of HO development at 1 year postoperatively. The overall radiographical incidence of HO was 20.4% (95%

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“…The use of postoperative radiotherapy (RT) and nonsteroidal anti-inflammatory drugs (NSAIDs) in preventing ossification has been extensively reported [6,13,14,15,21,27,29]. However, post-surgical irradiation is uncomfortable as patients have to be moved to a different department for treatment, and there is an associated risk of dislocation with the required changes of position.…”

Section: Introductionmentioning

confidence: 99%

Preoperative, single-fraction irradiation for prophylaxis of heterotopic ossification after total hip arthroplasty

Lonardi

Gioga

Coeli³

et al. 2001

International Orthopaedics (SICOT)

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We gave a single fraction of 750 cGy preoperatively (within 16 h of surgery) to 143 patients prior to total hip arthroplasty. The patients were evaluated for heterotopic ossification at 1, 3 and 6 months. The preoperative radiation did not affect the surgical procedure. After a median follow-up of 12 (6-24) months we encountered six patients with heterotopic ossifications of Brooker grade I-II. Potential late risks from ionising radiation should be considered when treating younger patients.Résumé Cent quarante trois patients ont reçus avant le remplacement prothétique de la hanche (en moyenne 16 heures avant l'intervention) une radiothérapie par une dose unique de 750 cGy. Les patients ont été évalués pour recherche des ossification hétérotopiques à 1, 3 et 6 mois. L'irradiation préopératoire n'a pas affecté la procédure chirurgicale. Avec une médiane de suivi de 12 (6-24) mois six patients ont présentés des ossifications hétérotopiques de niveau Brooker I-II. Les risques tardifs potentiels des radiations ionisantes doivent être pris en compte lorsque on traite des patients jeunes.

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Randomized trial comparing early postoperative irradiation vs. the use of nonsteroidal antiinflammatory drugs for prevention of heterotopic ossification following prosthetic total hip replacement

Cited by 58 publications

References 25 publications

Preoperative Irradiation for Prevention of Heterotopic Ossification Following Prosthetic Total Hip Replacement

Preoperative Irradiation for Prevention of Heterotopic Ossification Following Prosthetic Total Hip Replacement

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

Preoperative, single-fraction irradiation for prophylaxis of heterotopic ossification after total hip arthroplasty

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