Combined Radiotherapy and Indomethacin for the Prevention of Heterotopic Ossification after Total Hip Arthroplasty (Journal article)

Pakos, E. E./ Stafilas, K. S./ Tsekeris, P. G./ Politis, A. N./ Mitsionis, G./ Xenakis, T. A.


Background and Purpose: Heterotopic ossification (HO) is a frequent complication following total hip arthroptasty. The aim of this study was to evaluate the efficacy of combined radiotherapy and indomethacin as compared to indomethacin atone for the prevention of HO after hip arthroplasty. Patients and Methods: 96 patients were prospectively enrolled to receive either a single dose of postoperative radiotherapy of 7.0 Gy and indomethacin for the first 15 postoperative days or indomethacin atone for the same period. A historical group of 50 patients that received indomethacin atone served as control. Primary endpoint was the radiographic evidence of HO at 6 months. Secondary endpoints were the evaluation of factors related to HO development, side effects from each treatment, and group differences in the clinical assessment with the Merle d'Aubigne Score. Results: Four patients in the combined-therapy group developed HO compared to 13 patients in the indomethacin group (p < 0.05) and 13 patients in the historical group (p < 0.05). One patient each in the combined group and the historical group developed Brooker III HO (nonsignificant difference). Duration of surgery and congenital hip disease were associated with HO development in the indomethacin groups, while age and congenital hip disease showed such an association in the combined-therapy group. The side effects and mean Merle d'Aubigne Score did not differ significantly between the three groups. Conclusion: Combined radiotherapy and indomethacin was more efficacious in preventing HO after total hip arthroplasty compared to indomethacin atone and should be considered for future investigation.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών και Τεχνολογιών. Τμήμα Βιολογικών Εφαρμογών και Τεχνολογιών
Keywords: heterotopic ossification,total hip arthroplasty,radiotherapy,indomethacin,congenital hip disease,postoperative radiation-therapy,nonsteroidal antiinflammatory drugs,randomized-trial,ectopic ossification,predisposing factors,risk-factors,follow-up,prophylaxis,replacement,bone
URI: http://olympias.lib.uoi.gr/jspui/handle/123456789/16498
ISSN: 0179-7158
Item type: journalArticle
Link: <Go to ISI>://000268639800004
http://link.springer.com/content/pdf/10.1007%2Fs00066-009-1954-3.pdf
Item language: en
Item access scheme: campus
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών και Τεχνολογιών. Τμήμα Βιολογικών Εφαρμογών και Τεχνολογιών
Publication date: 2009
Abstract: Background and Purpose: Heterotopic ossification (HO) is a frequent complication following total hip arthroptasty. The aim of this study was to evaluate the efficacy of combined radiotherapy and indomethacin as compared to indomethacin atone for the prevention of HO after hip arthroplasty. Patients and Methods: 96 patients were prospectively enrolled to receive either a single dose of postoperative radiotherapy of 7.0 Gy and indomethacin for the first 15 postoperative days or indomethacin atone for the same period. A historical group of 50 patients that received indomethacin atone served as control. Primary endpoint was the radiographic evidence of HO at 6 months. Secondary endpoints were the evaluation of factors related to HO development, side effects from each treatment, and group differences in the clinical assessment with the Merle d'Aubigne Score. Results: Four patients in the combined-therapy group developed HO compared to 13 patients in the indomethacin group (p < 0.05) and 13 patients in the historical group (p < 0.05). One patient each in the combined group and the historical group developed Brooker III HO (nonsignificant difference). Duration of surgery and congenital hip disease were associated with HO development in the indomethacin groups, while age and congenital hip disease showed such an association in the combined-therapy group. The side effects and mean Merle d'Aubigne Score did not differ significantly between the three groups. Conclusion: Combined radiotherapy and indomethacin was more efficacious in preventing HO after total hip arthroplasty compared to indomethacin atone and should be considered for future investigation.
Journal name: Strahlentherapie Und Onkologie
Journal type: peer reviewed
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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