, Volume 95, Issue 1, pp 1–5 | Cite as

Heterotopic ossification after total hip arthroplasty: our experience

  • A. SpinarelliEmail author
  • V. Patella
  • M. Petrera
  • A. Abate
  • V. Pesce
  • S. Patella
Original Article


Heterotopic ossification is a condition characterized by the presence of mature lamellar bone and often bone marrow in soft tissues surrounding a major joint. It represents a common complication after total hip arthroplasty (THA). The etiology and predisposing factors are not completely known, but some authors reported that the implant of a non-cemented prosthesis seems to be associated with a greater incidence of HO. Two hundred and two non-cemented total hip arthroplasties were performed between October 1997 and February 2002. The mean age was 70.2 years. The average follow-up for 181 hips included in the study was 96 months (range, 72–120 months). A standard lateral approach (Hardinge) was performed for the implant of a non-cemented femoral component and a non-cemented acetabular component. Radiographs were done before and after surgery, at 1, 4 and 12 months postop, then every year. The incidence of HO was assessed in the antero-posterior view at each interval and graded according to Brooker classification. Out of 181 implants, HO was observed in 52 hips (28,7%). Heterotopic bone was graded as class I in 32 (17.7%) hips, class II in 14 (7.73%) hips, class III in 6 (3,3%) hips and class IV in none (0%). The mean preoperative Harris hip score was 48; at the last follow-up, the mean postoperative score was preoperatively to a mean of 89 points (range, 76–97 points) in HO Hip and of 91 points (range, 78–100 points) in the other Hip. In our experience, non-cemented THA led to a higher incidence of class I and II HO according to Brooker Classification, the incidence of HO is comparable to the rates reported in recent studies about the HO finding after a non-cemented THA, the importance of clinical symptoms in the presence of HO is very low.


Para-articular ossification  Heterotopic ossification Brooker classification Non-cemented THA 


Conflict of interest

The authors declare that they have no conflict of interest related to the publication of this manuscript and that no financial grants have been received for the study.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • A. Spinarelli
    • 1
    • 2
    Email author
  • V. Patella
    • 1
  • M. Petrera
    • 1
  • A. Abate
    • 1
  • V. Pesce
    • 1
  • S. Patella
    • 1
  1. 1.2nd Unit of Orthopaedic and TraumaUniversity of BariBariItaly
  2. 2.Unità Operativa di Ortopedia e Traumatologia IIAzienda Ospedaliero-Universitaria Policlinico Consorziale di BariBariItaly

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