Incidence of Heterotopic Ossification in Patients Receiving Radiation Therapy following Total Hip Arthroplasty

Panagiotis Koulouvaris,Thomas Sculco,David Sherr

doi:10.1155/2014/495426

Abstract

Heterotopic ossification (HO) is a frequent complication of hip surgery. In this study the incidence of HO is analyzed in high risk patients who received radiation therapy (RT) after total hip replacement (THA) with regular and miniposterolateral hip approach. Two hundred and thirty five high risk patients received a single dose of 700 rad after THA. The incidence of HO was 15.7%. The incidence of HO in the high risk subgroup with the miniincision was lower (5.7%) but not significantly different (P=0.230). Hypertrophic osteoarthritis was demonstrated to be the consistent predisposing factor for HO formation (P=0.005).

Highlights

Heterotopic ossification (HO) is bone formation in the soft tissues which develops after hip replacement surgery without a well-defined precipitating event (Figure 1)
A significant association was found between the rate of HO and primary OA in that 68.7% of the patients with HO had primary osteoarthritis
A significant association was noted between hypertrophic osteoarthritis; 26 (70.2%) of the patients with HO had hypertrophic osteoarthritis

Summary

Introduction

Heterotopic ossification (HO) is bone formation in the soft tissues which develops after hip replacement surgery without a well-defined precipitating event (Figure 1). Patients with a history of HO after previous hip surgery are at increased risk for recurrent HO formation [3]. Men with hypertrophic osteoarthritis have markedly higher levels of HO after THA [4]. Hips with markedly diminished motion and hypertrophic ossification before surgery were statistically more likely to have HO [2, 4]. Surgical approach and trauma may be a risk factor for the development of HO after THA. The posterior approach for THA is associated with the lowest incidence of HO formation [5, 6]. Postoperative fever for more than five days, superficial wound infection, and postoperative hematoma have been associated with HO [7, 8]

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