Para-Articular Ossifications After Total Hip Replacement

Ectopic Bone Formation Following Charnley hip Arthroplasty

“…It is known to be an intramembranous ossification (Nollen 1973, Rosendahl et al 1977). Nollen, in 1973, demonstrated that the concentration of alkaline phosphatases rose to significantly higher values in patients who developed EBF postoperatively than in those who did not. In the literature it is agreed that it is not possible to point out preoperatively factors which may lead to postoperative EBF.…”

Effect of ibuprofen on heterotopic ossification after hip replacement

“…When defined as radiographic calcifications, it has been reported in frequencies from 10 to 52 per cent (Eftekhar 1971, Nollen & Slooff 1973) and in one study as high as 90 per cent (Rosendahl et al 1977); it seems unrelated to the clinical result. Classified as radiographic changes showing a bony structure, heterotopic ossification occurs in 5-25 per cent (Eftekhar 1971, Hierton et al 1983) of patients after THR and, though this significantly decreases the range of motion (Jowsey et al 1977), re-operation for heterotopic bone is seldom necessary (Nollen & Slooff 1973).…”

Effect of a Diphosphonate on Para-Articular Ossification after total Hip Replacement

“…Their appearance is often associated with pain and slight swelling of the hip without redness, fever or signs of infection and may occasionally, over a period of 12 weeks, lead to severe limitation of passive and active hip movement. Some degree of ossification was seen in about 50 per cent of our patients and severe loss of function occiirrcd in 7 per cent (Nollen & Slooff 1973). Histologically the lesion resemhles that seen in myositis ossificans and paraosteoarthropathy ; it consists of normally mineralized osteoid and n woven bone structure which is remodelled to trabecular bone.…”

“…There is no way to assess in these patients whether the delay in calcification has a beneficial effect on joint mobility. The presciit study describes the effect of EHDP on a group of nonseptic ectopic ossifications of the locomotor apparatus that are comparable to the ossifications around large joints occurring in myositis ossificans or in the so-called paraosteoarthropathies observed in association with paraplegia (Nollen & Slooff 1973). However in contrast to these conditions, the occurrence of para-articular ossifications in total hip replacement is sufficiently frequent and predictable to offer the opportunity of a controlled study and to allow quantitative assessment of results.…”

“…In recent ycurs para-articular ossifications have been recognized with increasing frequency as a complication of total hip alloarthroplasty (Wilson et al 1972, Patterson & Brown 1972, Nollen & Slooff 1973. These ossifications first become visible on low kilovoltage X-rays 2 to 3 weeks after surgery as ill-defined opacifications of mottled appearance in the gluteal and/or psoas region.…”