Surgical excision of heterotopic bone after hip surgery followed by oral indomethacin application: is there a clinical benefit for the patient?

Early palsy of the sciatic nerve due to heterotopic ossification after surgery for fracture of the posterior wall of the acetabulum

“…25 Although the use of prophylactic adjuncts postoperatively following primary acetabular fixation for the prevention of HO has been investigated, 8,9,[11][12][13][26][27][28] their useafter excision of HO has not been extensively studied. Nonetheless, indometacin, 29 bisphosphonates, 30 irradiation 31 and free fat transplants 32 have all been used successfully to prevent recurrence after excision of HO formed as a result of hip surgery. Our patient received a single fraction of low-dose radiation 24 hours post-operative and 50 mg of indometacin twice daily for four weeks with no evidence of recurrence at the final follow-up.…”

Does a Plastic Drape Reduce Incidence of Heterotopic Ossification After Hip Resurfacing?

“…Other reports by Duck and Mylod [17] and Morrey et al [32] suggest no difference in HO formation and surgical approach used. HO prophylaxis is not without expense and complications, and surgical excision is an unwanted second procedure that has morbidity associated with it [11,20,27,37,39,40,57].…”

Heterotopic Ossification in Orthopaedic Trauma

“…The majority of authors have reported on the use of post-operative single-dose radiation for secondary prophylaxis against HO recurrence following surgical excision of HO from the hip, knee, or elbow, although the use of NSAIDs has also been reported. 20-23 Fortunately, in the setting of secondary HO prophylaxis following surgical excision, fracture nonunion is not a concern and both radiation and NSAIDs are ostensibly safe. The literature on the surgical excision of HO in the hip, knee, and elbow with secondary prophylaxis demonstrates significant improvements in pain and ROM with low rates of recurrence (0-19%) and acceptable rates of peri-operative complications (0-25%).…”