title: Determinants of heterotopic ossification after total hip replacement surgery.
abstract: The ability of various pre- or peri-operative variables to determine the risk of developing moderate to severe heterotopic ossification (HO) six to twelve months after surgery was investigated among 407 patients undergoing elective total hip replacement (THR) surgery and allocated to placebo in a randomised controlled trial evaluating NSA IDs-based prophylaxis for HO. Overall, 11 (30%) of the 37 patients undergoing revision surgery developed moderate to severe HO compared with 58 (16%) of the 370 patients undergoing primary THR; odds ratio (OR) 2.3, 95% confidence interval (CI) 1.1 to 4.9. Among patients undergoing primary THR , mutually adjusted analysis of collected independent risk factors demonstrated that receiving a transfusion of red cells or having general as well as epidural or spinal anaesthesia present as indicators of increased risk for developing moderate to severe HO. Patients who have undergone revision surgery have a significantly increased risk of clinically relevant ectopic bone, while among patients who have undergone primary THR surgery, those with indicators of excessive surgical bleeding are also at increased risk of clinically relevant HO.
authors.affiliation: The George Institute for International Health, University of Sydney, Lidcomb, NSW 1825, Australia. m.fransen@usyd.edu.au
authors.forename: Marlene
authors.initials: M
authors.lastname: Fransen
authors.forename: Bruce
authors.initials: B
authors.lastname: Neal
authors.forename: Ian D
authors.initials: ID
authors.lastname: Cameron
authors.forename: Ross
authors.initials: R
authors.lastname: Crawford
authors.forename: Garnet
authors.initials: G
authors.lastname: Tregonning
authors.forename: Julie
authors.initials: J
authors.lastname: Winstanley
authors.forename: Robyn
authors.initials: R
authors.lastname: Norton
mesh_terms: D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000775:Anesthesia, Spinal / Q000009:adverse effects; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D016063:Blood Loss, Surgical; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D009999:Ossification, Heterotopic / Q000209:etiology*; D010919:Placebos; D012086:Reoperation / Q000009:adverse effects; D012307:Risk Factors
chemical_list: D010919:Placebos