Summary
The prophylactic effect of nonsteroid anti-inflammatory drugs on the recurrence of high-grade periarticular heterotopic ossification after resection was studied in ten patients operated on for loosening of one or both components of a cemented total hip prosthesis. These drugs, given at a standard dosage for 1–3 weeks after surgery, prevented the recurrence of heterotopic ossification. In some patients the range of motion of their joint increased following surgery, while it remained unaffected in the majority. At follow-up 2–5 years after surgery, all patients walked well and there were no clinical or radiographs signs of loosening of the prosthetic components. It is concluded that treatment with NSAIDs following resection of periarticular heterotopic ossification prevents recurrence.
Similar content being viewed by others
References
Abrahamson S-E, Ahlgren S-A, Dahlström JA, Ohlin P, Stigsson L (1984) Ectopic bone after hip replacement. Excision and free fat transplants in four cases. Acta Orthop Scand 55:589–592
Ayers DC, McCollister Evarts C, Parkinson JR (1987) The prevention of heterotopic ossification in high-risk patients by low-dose radiation therapy after total hip replacement. J Bone Joint Surg [Am]68:423–1430
Brooker A, Bowerman JW, Robinson RA, Riley LH jr (1973) Ectopic ossification following total hip replacement: Incidence and a method of classification. J Bone Joint Surg [Am] 55: 1629–1632
Coventry MB, Scanlon PW (1981) The use of radiation to discourage ectopic bone. J Bone Joint Surg [Am] 63:201–208
Dahl HK (1975) Clinical observations (in Swedish). Symposium, MSD, pp 37–46
DeLee J, Ferrari A, Charnley J (1976) Ectopic bone formation following low-friction arthroplasty of the hip. Clin Orthop 121:53–59
Elmstedt E, Lindholm TS, Nilsson OS, Törnkvist H (1985) Effect of ibuprofen on heterotopic ossification after hip replacement. Acta Orthop Scand 56:25–27
Jowsey J, Coventry MB, Robins PR (1977) Heterotopic ossification: theoretical considerations, possible etiologic factors, and a clinical review of total hip artroplasty patients exhibiting this phenomenon. In: The Proceedings of the Hip Society. Mosby, St. Louis, pp 210–221
Kjaersgaard-Andersen P, Schmidt SA (1986) Indomethacin for prevention of ectopic ossification after hip arthroplasty. Acta Orthop Scand 57:12–14
Lidgren L, Nordström B (1979) Treatment of periarticular calcification after hip arthroplasty. Arch Orthop Trauma Surg 94:67–70
Mital MA, Garber JE, Stigson JT (1987) Ectopic bone formation in children and adolescents with head injuries: its management. J Pediatr Orthop 7:83–90
Nilsson OS, Bauer HCF, Brosjö O, Törnkvist H (1986) Influence of indomethacin on induced heterotopic bone formation in rats. Clin Orthop 207:239–245
Nollen AJG (1986) Effects of ethylhydroxydiphosphonate (EHDP) on heterotopic ossification. Acta Orthop Scand 57:358–361
Riska EB, Michelsson J-E (1979) Treatment of para-articular ossification after total hip replacement by excision and use of free fat transplants. Acta Orthop Scand 50:751–754
Ritter MA, Sieber J (1985) Prophylactic indomethacin for the prevention of heterotopic ossification following total hip arthroplasty. Clin Orthop 196:217–225
Rö J, Sudman E, Marton PF (1976) Effect of indomethacin on fracture healing in rats. Acta Orthop Scand 47:588–599
Sodemann B, Persson P-E, Nilsson OS (1988) Peri-articular heterotopic ossification after bilateral total hip replacement for primary coxarthrosis. Clin Orthop (accepted for publication)
Sodemann B, Persson P-E, Nilsson OS (1988) Prevention of heterotopic ossification after bilateral total hip replacement by non-steroid anti-inflammatory drugs. Clin orthop (accepted for publication)
Sodemann B, Persson P-E, Nilsson OS (1988) Prevention of peri-articular heterotopic ossification following total hip arthroplasty. Clinical experience with indomethacin and ibuprofen. Arch Orthop Trauma Surg (accepted for publication)
Thomas BJ, Amstutz HC (1985) Results of administration of diphosphonate for prevention of heterotopic ossification after total hip arthroplasty. J Bone Joint Surg [Am] 67:400–403
Törnkvist H, Dencker L, Danielsson BR, Nilsson OS (1984) Lack of effect of indomethacin on mesenchymal limb-bud cells in vitro. Acta Orthop Scand 55:378–380
Urist MR, DeLange RJ, Finerman GAM (1983) Bone cell differentiation and growth factors. Science 220:680–686
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sodemann, B., Persson, PE. & Nilsson, O.S. Nonsteroid anti-inflammatory drugs prevent the recurrence of heterotopic ossification after excision. Arch Orthop Trauma Surg 109, 53–56 (1990). https://doi.org/10.1007/BF00439378
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00439378