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[Heterotopic ossifications in total hip arthroplasty: prophylaxis and therapy].

Authors
  • Schauwecker, J1
  • Pohlig, F
  • Toepfer, A
  • Gollwitzer, H
  • von Eisenhart-Rothe, R
  • 1 Klinik für Orthopädie und Unfallchirurgie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 München, Deutschland. [email protected]
Type
Published Article
Journal
Der Orthopade
Publication Date
Jun 01, 2011
Volume
40
Issue
6
Pages
500–505
Identifiers
DOI: 10.1007/s00132-011-1759-9
PMID: 21584735
Source
Medline
License
Unknown

Abstract

Heterotopic ossification (HO) is a frequent and occasionally severe complication after total hip arthroplasty. Clinical symptoms of this benign abnormal bone formation are loss of mobility and local pain. The etiology and pathomechanisms are not yet completely understood. Overexpression of bone morphogenetic proteins and dysregulation of prostaglandin metabolism seem to be relevant. Medication with non-steroidal anti-inflammatory drugs (NSAIDs) and perioperative single dose radiotherapy are used for prophylaxis, whereby radiotherapy should only be performed in patients with a history of HO or additionally after resection of HO. From currently available data selective cyclooxygenase-2 inhibitors seem to have a preventive efficacy equal to the classical NSAIDs diclofenac and indometacin. This work discusses current knowledge about the pathophysiology, risk factors and the clinical approach for prevention and treatment of HO.

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