The effect of pulsed irrigation on the incidence of heterotopic ossification after total hip arthroplasty

Sneath, Robert; Bindi, Frank; Davies, Jonah; Parnell, Evette

doi:10.1054/arth.2001.23562

Cited by 21 publications

(28 citation statements)

References 15 publications

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“…Although HO etiology remains unclear, it has been postulated that osteoinductive growth factors are released as consequence of soft tissue trauma inducing the formation of HO [12–14]. HO is believed to reach its complete formation after 6 to 12 weeks post-operative and not to progress anymore after this period [15].…”

Section: Introductionmentioning

confidence: 99%

Influence of surgical approach on heterotopic ossification after total hip arthroplasty – is minimal invasive better? A case control study

Hürlimann

Schiapparelli

Rotigliano

et al. 2017

BMC Musculoskelet Disord

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BackgroundHeterotopic ossification (HO) is a well-known complication after total hip arthroplasty (THA).Recently, the trend is to operate THA minimally invasive being less traumatic than standard approaches and promising a faster return to activity. The purpose of the study was to investigate if minimal invasive surgery (MIS), leads also to less HO after THA.MethodsThis retrospective study included 134 consecutive patients undergoing THA. In 42 (31.3%) patients a standard modified anterolateral (STD-Watson-Jones), in 28 (20.9%) patients a standard transgluteal Bauer approach (STD-Bauer), in 39 (29.1%) a MIS direct anterior approach (AMIS) and in 25 (18.7%) patients a MIS anterolateral (MIS-AL) approach was used. Standard preoperative anterior-posterior and lateral radiographs were assessed for occurrence of HO. HO was classified according to Brooker. In addition, short- and long-term adverse events were noted. Data was statistically analyzed using Chi-square tests, analysis of variance, multivariate data analysis and Pearson’s correlation (p < 0.05).ResultsOverall, HO was found in 38 caucasian patients (28.4%) after THA. The STD-Watson-Jones group showed the highest HO rate (45.2% n = 19) with a significant difference to the AMIS (23.1% n = 9) and STD-Bauer approach (14.3% n = 4). No statistical difference was found to the MIS-AL approach (24.0% n = 6). Postoperative complications did not differ significantly except for a higher incidence of Trendelenburg`s sign in STD-Bauer.ConclusionsThe rate and degree of HO after THA were significantly different with regards to the surgical approach. The standard modified anterolateral approach resulted in the highest HO rate, however, MIS approaches showed higher HO rates than the STD-Bauer.

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Section: Introductionmentioning

confidence: 99%

Influence of surgical approach on heterotopic ossification after total hip arthroplasty – is minimal invasive better? A case control study

Hürlimann

Schiapparelli

Rotigliano

et al. 2017

BMC Musculoskelet Disord

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“…The process of HO is considered to be result of the differentiation of mesenchymal cells into osteoprogenitor cells, although the precise pathway is still unknown [12,13]. The natural setting of HO is extraarticular and occurs outside the joint capsule.…”

Section: Discussionmentioning

confidence: 99%

Heterotopic ossification after total hip arthroplasty: our experience

et al. 2011

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Heterotopic ossification is a condition characterized by the presence of mature lamellar bone and often bone marrow in soft tissues surrounding a major joint. It represents a common complication after total hip arthroplasty (THA). The etiology and predisposing factors are not completely known, but some authors reported that the implant of a non-cemented prosthesis seems to be associated with a greater incidence of HO. Two hundred and two non-cemented total hip arthroplasties were performed between October 1997 and February 2002. The mean age was 70.2 years. The average follow-up for 181 hips included in the study was 96 months (range, 72-120 months). A standard lateral approach (Hardinge) was performed for the implant of a non-cemented femoral component and a non-cemented acetabular component. Radiographs were done before and after surgery, at 1, 4 and 12 months postop, then every year. The incidence of HO was assessed in the antero-posterior view at each interval and graded according to Brooker classification. Out of 181 implants, HO was observed in 52 hips (28,7%). Heterotopic bone was graded as class I in 32 (17.7%) hips, class II in 14 (7.73%) hips, class III in 6 (3,3%) hips and class IV in none (0%). The mean preoperative Harris hip score was 48; at the last follow-up, the mean postoperative score was preoperatively to a mean of 89 points (range, 76-97 points) in HO Hip and of 91 points (range, 78-100 points) in the other Hip. In our experience, non-cemented THA led to a higher incidence of class I and II HO according to Brooker Classification, the incidence of HO is comparable to the rates reported in recent studies about the HO finding after a non-cemented THA, the importance of clinical symptoms in the presence of HO is very low.

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“…In the present study, the patient-related risk factors of HO after THA have been investigated to predict which patients are likely to have HO [1,2,10,13,19,20,23,24]. We measured BMD of patients who were scheduled to undergo THA to determine whether patients with higher BMD levels more often have HO after THA.…”

Section: Discussionmentioning

confidence: 99%

“…These factors were classified into three categories: (1) disease related (e.g., ankylosing spondylitis [1,13,24]); (2) operation technique related (e.g., soft tissue trauma [1] and surgical approach [19]); and (3) patient-related risk factors (e.g., male [2,20], hypertrophic osteoarthritis (OA) [1,2,14,20,23], and history of HO [10]). …”

Section: Introductionmentioning

confidence: 99%

Bone mineral density is not related to heterotopic ossification after total hip arthroplasty

Okano

Aoyagi

Osaki

et al. 2011

International Orthopaedics (SICOT)

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The effect of pulsed irrigation on the incidence of heterotopic ossification after total hip arthroplasty

Cited by 21 publications

References 15 publications

Influence of surgical approach on heterotopic ossification after total hip arthroplasty – is minimal invasive better? A case control study

Influence of surgical approach on heterotopic ossification after total hip arthroplasty – is minimal invasive better? A case control study

Heterotopic ossification after total hip arthroplasty: our experience

Bone mineral density is not related to heterotopic ossification after total hip arthroplasty

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