title: [Methods of the physical medicine therapy in prevention of heterotopic ossification after total hip arthroplasty].
abstract: OBJECTIVE
  In the prevention of periarticular heterotopic ossification (HO), a common complication after total hip arthroplasty (THA), nonsteroidal antiinflammatory drugs (NSAID) and irradiation are used. Some theories presume that local hypoxia of the soft tissue causes HO. The aim of this study was to investigate if the early use of pulsed electromagnetic fields (PEMF) could prevent this ossification since it accelerates the circulation and oxigenation of soft tissue.
  
  
  METHODS
  The study included three groups of the patients with primary THA. The group C consisted of 66 patients/79 hips who had only kinesitherapy in postoperative rehabilitation. The group B consisted of 117 patients/131 hips who had PEMF and interferential current (IC) which, on average, started on the 14th day after the surgery combined with the standard kinesitherapy. The group A consisted of 117 patients/131 hips who had PEMF from the third postoperative day and IC from, on average, the 14th postoperative day with the standard kinesitherapy. The classification of HO was done on a standard AP roentgenograms of the hips, taken at least one year after the surgery.
  
  
  RESULTS
  The overall HO was seen in 50.63% of the group C patients, in 43.51% of the B group and in 16.67% of the group A. Severe HO (III and IV class according to Brooker) was seen in 26.58% of the group C patients and in 6.10% of the group B, but none in the group A.
  
  
  CONCLUSIONS
  According to the obtained results an early treatment with PEMF could prevent severe HO and reduce the overall HO.
authors.affiliation: Klinicki centar Nis, Klinika za fizikalnu medicinu, rehabilitaciju i protetiku, Srbija. lakidika@bankerinter.net
authors.forename: Mirjana
authors.initials: M
authors.lastname: Kocić
authors.forename: Milica
authors.initials: M
authors.lastname: Lazović
authors.forename: Zoran
authors.initials: Z
authors.lastname: Kojović
authors.forename: Milorad
authors.initials: M
authors.lastname: Mitković
authors.forename: Sasa
authors.initials: S
authors.lastname: Milenković
authors.forename: Tamara
authors.initials: T
authors.lastname: Cirić
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D004574:Electromagnetic Fields; D026241:Exercise Movement Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000209:etiology / Q000517:prevention & control*; D026741:Physical Therapy Modalities