Prevention of heterotopic ossification (HO) after total hip replacement: randomized high versus low dose radiotherapy.
In a prospectively randomized study 60 hips at high risk for heterotopic ossification (HO) received prophylactic radiotherapy (RT). Randomization was performed between a low dose (LD-RT) of 5 x 2 Gy (arm A: 32 patients) and a high dose (HD-RT) of either 10 x 2 Gy (arm B1; 8 patients) or 5 x 3.5 Gy (arm B2; 20 patients). Relevant patient and risk factors were equally distributed in both treatment arms. 4 (7%) patients developed treatment failures. A short delay of RT after postoperative day (POD) 4 was significantly correlated with failure (p < 0.001). The results suggest no difference in prophylactic efficacy between LD-RT and HD-RT treatment. 2/19 (11%) patients receiving additional diphosphonates and 2/18 (11%) on no medication failed RT treatment, but none on indomethacin did so. In conclusion, immediate postoperative RT has been shown to be an effective prophylactic treatment.
Seegenschmiedt
M H
MH
Klinik und Poliklinik für Strahlentherapie, Universität Erlangen-Nürnberg, Germany.
Goldmann
A R
AR
Wölfel
R
R
Hohmann
D
D
Beck
H
H
Sauer
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006615:Hip / Q000473:pathology* / Q000528:radiation effects; D006622:Hip Prosthesis; D006801:Humans; D007213:Indomethacin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000188:drug therapy / Q000517:prevention & control* / Q000532:radiotherapy*; D011182:Postoperative Care; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy; D012307:Risk Factors; D017211:Treatment Failure
D004164:Diphosphonates; D007213:Indomethacin