Risk of Radiation-Induced Malignancy With Heterotopic Ossification Prophylaxis: A Case–Control Analysis

Sheybani, Arshin; Tennapel, M.J.; Lack, William D.; Clerkin, Patrick P.; Hyer, Daniel E.; Sun, Wenqing; Jacobson, Geraldine M.

doi:10.1016/j.ijrobp.2014.03.008

Cited by 15 publications

(9 citation statements)

References 24 publications

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“…The relatively low risk of joint stiffness after low‐dose radiation can be weighed against the decreased range of joint motion and potential ankylosis that can develop with HO. Regarding oncogenesis, a case‐control analysis has failed to demonstrate a significantly increased rate of malignancy in patients treated at this low dose of radiation . It bears noting, though, that the number of patients needed for adequate power is rarely met, and the theoretical risk of malignancy remains …”

Section: Clinical Features Of Heterotopic Ossificationmentioning

confidence: 99%

Heterotopic Ossification: A Comprehensive Review

et al. 2019

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Heterotopic ossification (HO) is a diverse pathologic process, defined as the formation of extraskeletal bone in muscle and soft tissues. HO can be conceptualized as a tissue repair process gone awry and is a common complication of trauma and surgery. This comprehensive review seeks to synthesize the clinical, pathoetiologic, and basic biologic features of HO, including nongenetic and genetic forms. First, the clinical features, radiographic appearance, histopathologic diagnosis, and current methods of treatment are discussed. Next, current concepts regarding the mechanistic bases for HO are discussed, including the putative cell types responsible for HO formation, the inflammatory milieu and other prerequisite “niche” factors for HO initiation and propagation, and currently available animal models for the study of HO of this common and potentially devastating condition. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

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Section: Clinical Features Of Heterotopic Ossificationmentioning

confidence: 99%

Heterotopic Ossification: A Comprehensive Review

et al. 2019

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“…RT is not only effective, but safe. Sheybani et al analyzed records of over 3500 patients who underwent a THR [50]. They concluded that there is no elevation of the malignancy risk after the radiation prophylaxis treatment.…”

Section: Diagnosis and Decision Makingmentioning

confidence: 99%

Heterotopic Ossification: A Challenging Complication of Total Hip Arthroplasty: Risk Factors, Diagnosis, Prophylaxis, and Treatment

Łęgosz

Otworowski

Sibilska

et al. 2019

BioMed Research International

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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.

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“… 7 Although it is cost effective and widely available, the use of NSAIDs for this indication also comes with disadvantages, including the decreased likelihood of patient compliance, risks of gastrointestinal side effects (reflux, dyspepsia, and peptic ulcer disease), risk of bleeding complications, risks of long-bone nonunion, and risks of nephrotoxicity. On the other hand, RT also carries its own disadvantages including a concern for secondary malignancies in the RT field, 8 , 9 and increased risk of fracture nonunion. 10 , 11 , 12 , 13 …”

Section: Introductionmentioning

confidence: 99%