Prevention of para-articular ossifications by radiotherapy after cementless total hip endoprosthesis implantation

Abstract

By means of a prospective study, concerning the postoperative rate of ossification after cementless total hip replacement, it was due to prove the efficacy of radiotherapy in preventing periarticular ossification. In 1992 arthroplasty was followed by radiotherapy of 50 hip joints as regular therapy. The radiation was performed with a focal dose of 8 Gy. Patients with bilateral cementless total hip replacement and radiotherapy only at one side were of special interest in this study. Within the 24th postoperative week in 28 (56%) of the radiated hip joins no periarticular ossifications were found. In 20 (40%) we found ossifications grade 1, in 1 case ossification grade II and in 1 further case ossification grade III following the classification of Arcq. By 8 patients with former cementless total hip replacement without postoperative radiotherapy, a significant reduction of the ossification rate was found in the contralateral hip joint treated by postoperative radiotherapy. The rate of ossification was reduced by 28%. In correlation to reduction of periarticular ossification the increase on the overall range of motion in the radiated hip joins was 10.9%. By none of the patients treated by radiotherapy we found a disturbed healing process, a deep infection or an early loosening of the endoprosthesis. Postoperative radiotherapy as regular therapy for prophylaxis of periarticular ossification after Cementless total hip replacement can subsequently be recommended.