title: Does indomethacin reduce heterotopic bone formation after operations for acetabular fractures? A prospective randomised study.
abstract: We have studied prospectively the effect of indomethacin on the development of heterotopic ossification (HO) after the internal fixation of acetabular fractures. After operation 107 patients randomly received either a six-week course of indomethacin or no treatment against HO. Plain radiographs of 101 patients at a mean of 7.9 months after surgery showed HO in 47.4% of the 57 patients who received indomethacin and in 56.8% of the 44 who did not. This difference was not statistically significant. Heterotopic ossification of Brooker class II or more was seen in four patients (7%) with prophylaxis and in one without (p = 0.51). Measurements of the volume of HO on 3-D CT reconstructions showed a median value of 1.5 cm3 in patients with indomethacin and 4.0 cm3 in those without (p = 0.28). When only the 57 patients in whom the operation was carried out through either a Kocher-Langenbeck or an extended iliofemoral approach were included the indomethacin group showed a median volume of 1.7 cm3 compared with 3.6 cm3. On plain radiographs Brooker class II or above was seen in 9.4% of the patients receiving indomethacin and in 4.8% of those who did not. Indomethacin was therefore not effective in preventing ectopic bone formation after surgery for acetabular fractures. There was a significant association of male gender with volume of HO using a non-parametric analysis of variance.
authors.affiliation: University of Berne, Inselspital, Switzerland.
authors.forename: J M
authors.initials: JM
authors.lastname: Matta
authors.forename: K A
authors.initials: KA
authors.lastname: Siebenrock
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D018890:Chemoprevention; D016009:Chi-Square Distribution; D005260:Female; D005270:Femur Head / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000601:surgery; D007213:Indomethacin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000517:prevention & control*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control*; D011446:Prospective Studies; D011856:Radiographic Image Enhancement / Q000379:methods; D012737:Sex Factors; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin