[Prevention of para-articular ossifications after endoprosthetic hip joint replacement by postoperative irradiation].
In a prospectively randomized study, 137 patients with 141 hips at high risk for heterotopic ossification (HO) received prophylactic radiation therapy (RT). Patients were randomly assigned to a low-dose regimen of five fractions of 2 Gy each (n = 73) or a high-dose regimen of either 10 fractions of 2 Gy each (n = 7) or five fractions of 3.5 Gy each (n = 61). Treatment outcome was assessed by comparing immediately postoperative radiographs with radiographs obtained at least 6 months after hip surgery (Brooker grading score). Positive responses (ie, effective prophylaxis of HO) were seen in 129 (91.5%) hips. Treatment failures were observed in 12 (8.5%). Use of a nonsteroidal antiinflammatory drug (NSAID) lowered the failure rate in both groups. High RT dose with a short duration (< or = 9 days) and use of an NSAID was significantly (p = 0.009) correlated with treatment success. RT delivered within a few days after hip surgery is effective in preventing HO, even in high-risk patients, and provides an alternative of at least equal value for patients with contraindications to long-term medication with either NSAIDs or corticosteroids.
Wölfel
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Unfallchirurgische Abteilung, Universität Erlangen-Nürnberg.
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Günther
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Sauer
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Beck
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Hohmann
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D011446:Prospective Studies; D011859:Radiography; D011882:Radiotherapy, High-Energy; D016059:Range of Motion, Articular / Q000528:radiation effects
Prophylaxe paraarticulärer Ossifikationen nach endoprothetischem Hüftgelenkersatz durch postoperative Bestrahlung.