Randomized trial comparing preoperative versus postoperative irradiation for prevention of Heterotopic ossification following prosthetic total hip replacement: Preliminary results

Gregoritch, Steven J.; Chadha, Manjeet; Pelligrini, Vincent D.; Rubin, Philip; Kantorowitz, David A.

doi:10.1016/0360-3016(94)90519-3

Cited by 117 publications

(58 citation statements)

References 16 publications

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“…Lonardi et al [19] examined just the rate of heterotopic ossification in patients treated with radiation within 16 hours before THA and found the rate of heterotopic ossification to be six of 143 (4.2%). Other studies have found the rate of heterotopic ossification ranges from 5% to 48% in patients irradiated for heterotopic ossification prophylaxis between 4 to 20 hours before THA [11,13,18,31].…”

Section: Discussionmentioning

confidence: 98%

“…The rationale for this study is based on the premise that prophylaxis may be more effective if given closer to the time of injury rather than immediately postoperatively [25]. In the THA population, preoperative radiation therapy has been safely utilized for heterotopic ossification prophylaxis [11,19]; however, to our knowledge, this has not been investigated for patients with acetabular fracture. In comparing preoperative radiation therapy to postoperative radiation therapy, we did not observe a difference in the frequency and severity of heterotopic ossification for patients with acetabular fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Although preoperative radiation therapy has been shown to be safe and effective in the prevention of heterotopic ossification in elective THA procedures [11,13,18,19,31], there are no reports to our knowledge of this being done in the trauma patient setting. The exact pathophysiology of heterotopic ossification is not completely understood; however, some have theorized that initial traumatic insult is the root cause of the heterotopic bone [17,24].…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative external beam radiation has been used for heterotopic ossification prophylaxis in the THA population [11,13,18,19,31]. However, the literature provides little insight regarding the efficacy of preoperative radiation therapy for heterotopic ossification in patients with acetabular fracture.…”

Section: Introductionmentioning

confidence: 99%

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Is Preoperative Radiation Therapy as Effective as Postoperative Radiation Therapy for Heterotopic Ossification Prevention in Acetabular Fractures?

Archdeacon

dʼHeurle

Nemeth³

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Prophylactic approaches to prevent heterotopic ossification after acetabular fracture surgery have included indomethacin and/or single-dose external beam radiation therapy administered after surgery. Although preoperative radiation has been used for heterotopic ossification prophylaxis in the THA population, to our knowledge, no studies have compared preoperative and postoperative radiation therapy in the acetabular fracture population. Questions/purposes We determined whether heterotopic ossification frequency and severity were different between patients with acetabular fracture treated with prophylactic radiation therapy preoperatively and postoperatively. Methods Between January 2002 and December 2009, we treated 320 patients with a Kocher-Langenbeck approach for acetabular fractures, of whom 50 (34%) were treated with radiation therapy preoperatively and 96 (66%) postoperatively. Thirty-four (68%) and 71 (74%), respectively, had 6-month radiographs available for review and were included. For hospital logistical reasons, patients who underwent operative treatment on a Friday or Saturday received radiation therapy preoperatively, and all others received it postoperatively. The treatment groups were comparable in terms of most demographic parameters, injury severity, and fracture patterns. Sixmonth postoperative radiographs were reviewed and graded according to Brooker. Followup ranged from 6 to 93 months and 6 to 97 months for the preoperative and postoperative groups, respectively. Post hoc power analysis showed our study was powered to detect a difference of 22% or more between patients with severe heterotopic ossification. Sample size calculations showed 915 subjects would be needed to detect a 5% relative difference in severe heterotopic ossification status between groups. Results We detected no difference in heterotopic ossification frequency between the preoperative (eight of 36, 22%) and postoperative (19 of 71, 27%) groups (p = 0.609). There was also no difference in heterotopic ossification severity between groups (p = 0.666). Two of 36 (6%) in the preoperative group and three of 71 (4%) in the postoperative group developed clinically significant

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is Preoperative Radiation Therapy as Effective as Postoperative Radiation Therapy for Heterotopic Ossification Prevention in Acetabular Fractures?

Archdeacon

dʼHeurle

Nemeth³

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…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]. On the other hand, NSAIDs have been extensively used perioperatively for the prevention of HO after THA.…”

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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Musculoskeletal Disorders

Mak

Wong

2023

Medical Radiology

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Randomized trial comparing preoperative versus postoperative irradiation for prevention of Heterotopic ossification following prosthetic total hip replacement: Preliminary results

Cited by 117 publications

References 16 publications

Is Preoperative Radiation Therapy as Effective as Postoperative Radiation Therapy for Heterotopic Ossification Prevention in Acetabular Fractures?

Is Preoperative Radiation Therapy as Effective as Postoperative Radiation Therapy for Heterotopic Ossification Prevention in Acetabular Fractures?

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

Musculoskeletal Disorders

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