Radiation induced soft tissue sarcoma and bone sarcoma

“…We were unable to find data on potential long-term complications of radiation or NSAIDs. However, the existence and clinical meaning of suggested potential long-term complications, such as soft tissue or osseous malignancies attributable to radiation [16,17] or prosthetic loosening attributable to NSAIDs [26], are more than questionable, especially considering the prohibitively long latencies of such events at the average age of most patients undergoing hip surgery. A recent study reported no increase in implant migration after 5 years in patients who had received NSAIDs or radiation to prevent HO [13].…”

Section: Discussionmentioning

confidence: 99%

Prophylaxis of Heterotopic Ossification of the Hip: Systematic Review and Meta-Analysis

Vavken

Castellani

Sculco

2009

Clin Orthop Relat Res

105

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Heterotopic ossification (HO) is a potentially severe, if infrequent, complication in hip surgery, and uncertainty exists regarding whether to use NSAIDs or radiation in its prevention. Thus, we systematically reviewed the literature in MedLine, EMBASE, CINAHL, and the Cochrane Controlled Trial Register and, after ruling out publication bias and data heterogeneity, performed a meta-analysis of randomized, controlled trials to assess effectiveness and complications of NSAIDs and radiation in the prevention of HO. We identified nine studies reporting on effectiveness and complications including a total of 1295 patients. The pooled risk ratio for the effectiveness in HO prevention was 0.96 (95% confidence interval, 0.88-1.06) and was independent of the type of surgery (THA or open reduction and internal fixation). There was no association with gender, age, length of followup, or year of publication. The risk ratio for associated complications was 0.79 (95% confidence interval, 0.45-1.41), and, again, was independent of the aforementioned factors. We found no evidence for a statistically significant or clinically important difference between NSAIDs or radiation in preventing HO.

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“…the excision of ectopic bone) [18]. However, radiotherapy is by no means ideal since it carries a number of potential risks such as malignancy, genetic mutations, and gonadal effects [19,20]. Bisphosphonate use remains controversial after a Cochrane review [21] failed to find conclusive evidence of efficacy.…”

Section: Clinical Problemsmentioning

confidence: 99%