Randomized trial comparing preoperative irradiation versus the use of non-steroidal-antiinflammatory drugs for prevention of heterotopic ossification following prothetic total hip replacement

Kölbl, Oliver; Knelles, D.; Barthel, Th.; Flentje, M.; Eulert, J.

doi:10.1016/s0959-8049(97)84881-2

Cited by 2 publications

(11 citation statements)

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“…1). Six studies reported on primary THA [4,15,[18][19][20]28] and three on open reduction and internal fixation (ORIF) of acetabular fractures [5,21,27]. Martini et al [20] reported specifically on the perioperative adverse events in patients receiving NSAIDs and radiation.…”

Section: Methodsmentioning

confidence: 99%

“…All other studies reported on the incidence of HO as a primary end point. Four studies mentioned side effects [15,18,19,28], whereas Burd et al [5] reported they observed no side effects. Only one study referred to the intention-to-treat principle [5].…”

Section: Methodsmentioning

confidence: 99%

“…Only one study referred to the intention-to-treat principle [5]. Data regarding the incidence of HO despite prophylaxis could be extracted from eight studies [4,5,15,18,19,21,27,28], and a total of 1295 patients could be included (661 who received NSAIDs versus 634 who received radiation). Five trials provided data for analysis of complications associated with treatments [15,[18][19][20]28].…”

Section: Methodsmentioning

confidence: 99%

“…Data regarding the incidence of HO despite prophylaxis could be extracted from eight studies [4,5,15,18,19,21,27,28], and a total of 1295 patients could be included (661 who received NSAIDs versus 634 who received radiation). Five trials provided data for analysis of complications associated with treatments [15,[18][19][20]28]. Generally, data regarding complications were reported less systematically than data for effectiveness, but we were able to extract information for 992 patients (507 who received NSAIDs versus 485 who received radiation).…”

Section: Methodsmentioning

confidence: 99%

“…However, it is not surprising a couple studies recommend prevention in patients undergoing hip surgery [3,9,10]. NSAIDs and radiation, two distinct treatment options, are the mainstays of HO prevention, both of which are reportedly effective for that purpose [9,10,19]. Numerous randomized, controlled trials comparing NSAIDs and radiation in the prevention of HO have been published, but their results are inconsistent [2,5,18,25,28].…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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Is Preoperative Radiation Therapy as Effective as Postoperative Radiation Therapy for Heterotopic Ossification Prevention in Acetabular Fractures?

Archdeacon

dʼHeurle

Nemeth³

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Prophylactic approaches to prevent heterotopic ossification after acetabular fracture surgery have included indomethacin and/or single-dose external beam radiation therapy administered after surgery. Although preoperative radiation has been used for heterotopic ossification prophylaxis in the THA population, to our knowledge, no studies have compared preoperative and postoperative radiation therapy in the acetabular fracture population. Questions/purposes We determined whether heterotopic ossification frequency and severity were different between patients with acetabular fracture treated with prophylactic radiation therapy preoperatively and postoperatively. Methods Between January 2002 and December 2009, we treated 320 patients with a Kocher-Langenbeck approach for acetabular fractures, of whom 50 (34%) were treated with radiation therapy preoperatively and 96 (66%) postoperatively. Thirty-four (68%) and 71 (74%), respectively, had 6-month radiographs available for review and were included. For hospital logistical reasons, patients who underwent operative treatment on a Friday or Saturday received radiation therapy preoperatively, and all others received it postoperatively. The treatment groups were comparable in terms of most demographic parameters, injury severity, and fracture patterns. Sixmonth postoperative radiographs were reviewed and graded according to Brooker. Followup ranged from 6 to 93 months and 6 to 97 months for the preoperative and postoperative groups, respectively. Post hoc power analysis showed our study was powered to detect a difference of 22% or more between patients with severe heterotopic ossification. Sample size calculations showed 915 subjects would be needed to detect a 5% relative difference in severe heterotopic ossification status between groups. Results We detected no difference in heterotopic ossification frequency between the preoperative (eight of 36, 22%) and postoperative (19 of 71, 27%) groups (p = 0.609). There was also no difference in heterotopic ossification severity between groups (p = 0.666). Two of 36 (6%) in the preoperative group and three of 71 (4%) in the postoperative group developed clinically significant

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Randomized trial comparing preoperative irradiation versus the use of non-steroidal-antiinflammatory drugs for prevention of heterotopic ossification following prothetic total hip replacement

Cited by 2 publications

References 0 publications

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

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

Is Preoperative Radiation Therapy as Effective as Postoperative Radiation Therapy for Heterotopic Ossification Prevention in Acetabular Fractures?

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