title: Indomethacin versus radiation therapy for heterotopic ossification after hip arthroplasty.
abstract: This study compared the efficacy and cost of radiation therapy with indomethacin in the prophylaxis of heterotopic ossification following total hip replacement. Twenty-two patients received a radiation dose of 10 Gy in five fractions, 28 patients 8 Gy in one fraction, and 27 patients 25 mg oral indomethacin three times a day for either 7 or 21 days. Patients at higher risk for heterotopic ossification were more likely to receive radiation therapy than indomethacin. At a mean follow-up of 2 years, there were no differences in failure rates between the high-risk patients treated with radiation and the low-risk patients treated with indomethacin. Currently, the patient-billed cost of radiation is $1400 whereas the cost for indomethacin is approximately $100. Indomethacin appears to be as effective as radiation therapy in patients at low to moderate risk for heterotopic ossification and offers significant cost savings.
authors.affiliation: Division of Orthopedics, Scripps Clinic, La Jolla, Calif 92037, USA.
authors.forename: D D
authors.initials: DD
authors.lastname: D'Lima
authors.forename: E J
authors.initials: EJ
authors.lastname: Venn-Watson
authors.forename: P
authors.initials: P
authors.lastname: Tripuraneni
authors.forename: C W
authors.initials: CW
authors.lastname: Colwell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000209:etiology / Q000517:prevention & control*; D011878:Radiotherapy; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin