Heterotopic ossification after surface replacement arthroplasty and total hip arthroplasty: a randomized study.
With a randomized clinical trial, we compared the incidence and severity of heterotopic ossification in cohorts of patients who have undergone either surface replacement arthroplasty or total hip arthroplasty at a minimum follow-up of 1 year. Surface replacement arthroplasty group had a significantly higher rate of severe heterotopic ossification (Brooker grades 3-4) than the total hip arthroplasty group, 12.6% (13/103) vs 2.1% (2/97) respectively (P = .02). Grade 4 heterotopic ossification was observed (4.9%, 5/103) exclusively in the surface replacement arthroplasty group. Patients with severe heterotopic ossification had significantly inferior functional outcome scores. Surgeons offering surface replacement must be aware of this risk and use meticulous surgical technique and consider routine prophylaxis against heterotopic ossification.
Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada.
Krishna Reddi Boddu Siva
KR
Rama
Pascal-André
PA
Vendittoli
Muthu
M
Ganapathi
Rene
R
Borgmann
Alain
A
Roy
Martin
M
Lavigne
D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000453:epidemiology* / Q000503:physiopathology* / Q000517:prevention & control; D015207:Osteoarthritis, Hip / Q000601:surgery; D011859:Radiography; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult