Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Feb 1991
ReviewPeriarticular heterotopic ossification after total hip arthroplasty. Risk factors and consequences.
The formation of periarticular heterotopic bone after total hip arthroplasty is a frequent complication. The reported occurrences concerning this complication vary considerably in different reports, ranging from 15% to 90% with significant amounts in 1%-27% of the cases. Heterotopic ossification (HO) starts with the surgical operation, and the extent is well delineated on roentgenograms after six to 12 weeks. ⋯ Patients at risk seem to be those with HO after a previous surgical operation, patients suffering from certain types of ankylosing spondylitis, otherwise healthy men with osteoarthrosis, patients with hypertrophic osteoarthrosis, and patients operated upon for fresh fractures or other posttraumatic conditions. The surgical technique and the local tissue trauma probably moderate both the occurrence and amount of HO. HO does not seem to cause pain or to decrease hip muscle strength but does limit hip mobility in cases with significant amount of ossification.
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Clin. Orthop. Relat. Res. · Feb 1991
ReviewTotal hip arthroplasty. The role of antiinflammatory medications in the prevention of heterotopic ossification.
Postoperative prophylaxis with antiinflammatory medications, primarily indomethacin, is extremely effective in preventing the severest degrees of heterotopic ossification (HO) after a total hip arthroplasty (THA) and the recurrence of excised HO developed after a previous hip surgery. Prophylaxis with indomethacin should be given in 25-mg doses three times daily for at least three weeks, starting on the first postoperative morning. ⋯ However, although no major complications have been reported regarding the use of antiinflammatory medications in the prevention of HO after THA, orthopedic surgeons prescribing such treatment should be aware of their contraindications as well as early and late side effects. Since several antiinflammatory agents are reported to be effective in preventing HO, future reports dealing with HO after THA should always include information about the postoperative antiinflammatory treatment used.
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Clin. Orthop. Relat. Res. · Feb 1991
ReviewA clinical perspective on common forms of acquired heterotopic ossification.
The clinical courses of heterotopic ossification (HO) as a consequence of trauma and central nervous system insults have many similarities as well as dissimilarities. Detection is commonly noted at two months. The incidence of clinically significant HO is 10%-20%. ⋯ Surgical timing differs according to etiology: traumatic HO may be resected at six months; spinal cord injury HO is excised at one year; and traumatic brain injury HO is removed at 1.5 years. A small number of patients have progression of HO with medicinal treatment and recurrence after resection. The patients seem recalcitrant to present treatment methods regardless of the HO etiology.