Document Detail


Incidence of heterotopic ossifcation and effects of various prophylactic methods after hip resurfacing.
MedLine Citation:
PMID:  22035483     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
A retrospective analysis of 1000 hips in 838 patients was conducted to determine the effcacy of alterations made throughout the series to the prophylactic protocol used to minimize the incidence of heterotopic ossifcation (HO) after hip resurfacing. Materials and Methods: Four groups were determined following the initiation of these changes. Initially, the patients received indomethacin and 1000 milliliters of both saline and duobiotic (group 1). In group 2, a single pre-operative 700 cGy radiotherapy session was added for males undergoing one-stage bilateral procedures or the second stage of a two-stage procedure when HO had formed on the frst hip. In group 3, the volume of saline used to clean the wound after implantation was increased from 1000 to 2000 milliliters, while the 1000 milliliters of duobiotic remained throughout the series. Finally, the use of a plastic drape was added to collect bone debris during the reaming of the femoral head in group 4. Chi-square analyses were conducted between groups to identify signifcant decreases in the prevalence of HO. Results: Group 3 showed a reduction in incidence of all HO grades combined, and severe HO only compared with group 2 (p = 0.003 and p = 0.007, respectively). A decrease in severe HO incidence was observed between group 1 and group 2 in males who underwent bilateral surgery (p = 0.048). In addition, there was a signifcant decrease in the incidence of both all HO grades (p = 0.0001) and severe HO (p = 0.029) between groups 1 and 4. In contrast to most studies that have assessed the individual effect of prophylactic methods in a single protocol, the present study confrmed the effectiveness of combining indomethacin and radiation therapy in high-risk patients, as well as copious pulse lavage of the wound in reducing the incidence of HO. The use of the plastic drape did not confer any additional gain.
Authors:
Michel J Le Duff; Kohtaroh B Takamura; Harlan C Amstutz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bulletin of the NYU hospital for joint diseases     Volume:  69 Suppl 1     ISSN:  1936-9727     ISO Abbreviation:  Bull NYU Hosp Jt Dis     Publication Date:  2011  
Date Detail:
Created Date:  2011-10-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101300541     Medline TA:  Bull NYU Hosp Jt Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  36-41     Citation Subset:  IM    
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