Ketorolac prophylaxis against heterotopic ossification after hip replacement.
Three hundred three patients undergoing total hip replacement were enrolled in a prospective, randomized, double-blind clinical study of heterotopic bone formation. All the procedures were primary arthroplasties done for osteoarthritis using an anterolateral approach. Patients with spondyloarthropathy, previous surgery, or previous head or pelvic trauma were excluded. A total of 152 patients received 60 mg of ketorolac intraoperatively and 30 mg every 8 hours for 5 doses postoperatively; another 151 patients received no prophylaxis for heterotopic bone formation. Patients in each group had similar postoperative courses. No complications related to ketorolac use were seen. There was significantly less heterotopic bone formation in the ketorolac-treated group. Severe heterotopic bone formation did not develop in any treated patient, as compared with 11 untreated patients. It is concluded that ketorolac is useful as prophylaxis to prevent heterotopic bone formation. Treatment with ketorolac is completed during hospitalization; therefore, compliance is ensured. This treatment is convenient, but not necessarily more effective than other treatments.
Pritchett
J W
JW
Department of Orthopaedic Surgery, University of Washington, Seattle 98144, USA.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D020910:Ketorolac; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications; D011446:Prospective Studies; D014046:Tolmetin / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D014046:Tolmetin; D020910:Ketorolac