title: Heterotopic ossification following total hip replacement for acetabular fractures.
abstract: Early total hip replacement (THR) for acetabular fractures offers accelerated rehabilitation, but a high risk of heterotopic ossification (HO) has been reported. The purpose of this study was to evaluate the incidence of HO, its associated risk factors and functional impact. A total of 40 patients with acetabular fractures treated with a THR weres retrospectively reviewed. The incidence and severity of HO were evaluated using the modified Brooker classification, and the functional outcome assessed. The overall incidence of HO was 38% (n = 15), with nine severe grade III cases. Patients who underwent surgery early after injury had a fourfold increased chance of developing HO. The mean blood loss and operating time were more than twice that of those whose surgery was delayed (p = 0.002 and p < 0.001, respectively). In those undergoing early THR, the incidence of grade III HO was eight times higher than in those in whom THR was delayed (p = 0.01). Only three of the seven patients with severe HO showed good or excellent Harris hip scores compared with eight of nine with class 0, I or II HO (p = 0.049). Associated musculoskeletal injuries, high-energy trauma and head injuries were associated with the development of grade III HO.The incidence of HO was significantly higher in patients with a displaced acetabular fracture undergoing THR early compared with those undergoing THR later and this had an adverse effect on the functional outcome.
authors: Hôpital du Sacré Cœur de Montréal, University of Montreal, 5400 Gouin Ouest, Local C-2095, Montréal, Québec H4J 1C5, Canada. ochemaly8@gmail.com
authors: O
authors: O
authors: Chémaly
authors: J
authors: J
authors: Hebert-Davies
authors: D M
authors: DM
authors: Rouleau
authors: B
authors: B
authors: Benoit
authors: G Y
authors: GY
authors: Laflamme
mesh_terms: D000077:Acetabulum / Q000293:injuries*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome