Total hip replacement for patients who have ankylosing spondylitis. The importance of the formation of heterotopic bone and of the durability of fixation of cemented components.

Kilgus, Douglas J.; Namba, Robert S.; Gorek, J E; Cracchiolo, Andrea; Amstutz, Harlan C.

doi:10.2106/00004623-199072060-00006

Cited by 64 publications

(38 citation statements)

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“…This was not evident in our study, nor in the report by Pedersen et al [15]. Many authors have shown that pre-existing HO after contralateral hip surgery is associated with an increased incidence [1,7,11,12,15,18,20]. DeLee et al [6] report an incidence of 92% in patients who developed HO after contralateral THA.…”

Section: Discussioncontrasting

confidence: 61%

Heterotopic ossification after total hip arthroplasty

Toom

Haviko

Rips

2001

International Orthopaedics

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We studied 178 patients undergoing total hip arthroplasty (66 men and 112 women) retrospectively, with regard to the incidence and severity of heterotopic ossification and the significance of postoperative prophylaxis with non-steroid anti-inflammatory drugs. The overall incidence of heterotopic ossification was 32% 1 year after surgery. The factors increasing the incidence were male gender, previous arthroplasty of the contralateral hip joint, previous surgery on the hip, absence of preoperative treatment with non-steroidal anti-inflammatory drugs and an operating time of more than 100 min. The incidence of heterotopic ossification was lower in the patients of 0 blood group.Résumé Nous avons étudié la fréquence et la sévérité d'ossification hétérotopique dans 178 cas d'arthroplastie totale de la hanche avec une prophylaxie postopératoire par AINS. Une année après la chirurgie la fréquence totale était de 32%. Les facteurs qui augmentent le risque étaient le sexe masculin, une arthroplastie de la hanche contrelaterale, des antécédents chirurgicaux sur hanche, l'absence de traitement préopératoire par AINS et une durée opératoire de plus de 100 min. La fréquence d'ossification hétérotopique était inférieure chez les patients du groupe sanguin 0. IntroductionHeterotopic ossification (HO) is a significant complication of total hip arthroplasty (THA). An incidence, without prophylaxis, has been reported of between 8% and 90% [1,13]. Two methods of treatment are commonly used, non-steroidal anti-inflammatory agents (NSAID) and irradiation [5]. The aim of this study was to record the incidence and severity of HO after THA and to determine the relevance of risk factors. Materials and methodsThe notes of 178 patients (66 men and 112 women) who underwent THA in the Clinic of Traumatology and Orthopaedics, Tartu University, between 1995 and 1996 were reviewed retrospectively. The requirement for THA was degenerative arthritis in 160 cases, rheumatoid arthritis in nine cases and trauma of the hip in nine. All patients were treated prophylactically with NSAIDs up to 30 days postoperatively. All patients also received antithrombotic prophylaxis with 0.3 ml (2500 IU) fractioned heparine (Fraxiparine) daily. The prostheses used were all cemented; Lubinus IP in 120 cases, Lubinus SP II in 51 cases and the Link Dysplasia hip prosthesis in seven. In all cases the posterolateral approach was used.The data collected included age, gender, diagnosis, surgery on the ipsi-and contralateral hip performed before or after THA, the operating time, the type of anaesthesia, blood loss and preoperative treatment with NSAIDs. The preoperative anteroposterior radiographs were reviewed, and those taken on the 1st postoperative day and at 3, 6, 9 and 12 months postoperatively, and were assessed according to the Brooker classification, in which HO is classified at stages I-IV, of which stages III and IV are clinically and functionally significant [4].The analysis of preoperative radiographs included the assessment of osteophytes and the s...

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Section: Discussioncontrasting

confidence: 61%

Heterotopic ossification after total hip arthroplasty

Toom

Haviko

Rips

2001

International Orthopaedics

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“…Some studies have reported on heterotopic bone formation after bilateral total hip arthroplasty (Nollen and Slooff 1973, DeLee et al 1976, Ritter and Vaughan 1977, Kromann-Andersen et al 1980, Lindholm et al 1986, Sunderam and Murphy 1986, Sodemann et al 1988, Kilgus et al 1990). Among these, only Sodemann et al (1988) evaluated patients without treatment with anti-inflammatory drugs in the postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Heterotopic bone formation following hip arthroplasty: A retrospective study of 65 bilateral cases

Kjægaard-Andersen¹,

Steinke²,

Hougaard³

et al. 1991

Acta Orthopaedica Scandinavica

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“…However, when the results are analyzed, there appears to be an almost universally significant increase in the range of movement, which is maintained in the long-term thereafter, with few cases of significant HO or re-ankylosis. Higher rates of HO after THA have been reported in AS patients who have undergone repeat operations, who have experienced postoperative infection, and, who were treated with a transtrochanteric approach [35]. These patients should be considered for HO prophylaxis with indomethacin or low-dose radiation [4].…”

Section: Outcomementioning

confidence: 99%

“…Cemented THA [10,13,14,[21][22][23][24][25][26][27][28][29] (Table 1), Cementless THA [10,17,18,[30][31][32] (Table 2) (Figure 2A), and more recently resurfacing arthroplasty (HRA) [31,[33][34][35][36][37] (Table 3 and Figure 2B) Pain relief after hip replacement in AS has been reported by most authors. A high percentage of patients continue to remain pain free even in the long term.…”

Section: Outcomementioning

confidence: 99%

Hip Replacement in Patients with Ankylosing Spondylitis

Sharma¹

2013

Orthop Muscul Syst

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Hip involvement in Ankylosing spondylitis (AS) patients with preexisting spinal deformity further compromises their posture and limits their mobility. Although medical management has improved the outcome and may have reduced the need for surgery, orthopedic surgery and in particular Total Hip Arthroplasty (THA) is often required to manage pain and restore function and mobility.THA remains the most effective treatment strategy to relieve pain and improve ambulatory status in these patients. However many important considerations regarding preoperative evaluation and surgical technique must be taken into account in order to improve the results of THA in this subgroup of patients.

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Total hip replacement for patients who have ankylosing spondylitis. The importance of the formation of heterotopic bone and of the durability of fixation of cemented components.

Cited by 64 publications

References 0 publications

Heterotopic ossification after total hip arthroplasty

Heterotopic ossification after total hip arthroplasty

Heterotopic bone formation following hip arthroplasty: A retrospective study of 65 bilateral cases

Hip Replacement in Patients with Ankylosing Spondylitis

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