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Risk factors for heterotopic ossification and spur formation after total knee arthroplasty

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The present study investigated the incidence and risk factors of heterotopic ossification (HO) after implantation of knee prosthesis.

Materials and methods

We undertook a retrospective cohort study in 434 cases (363 patients) treated with a total knee replant using a Press-Fit-Condylar (P.F.C.®Sigma®) prosthesis. The occurrence of HO in radiograph after a follow-up period of 11.2 ± 2.4 months was correlated in a regression model with a variety of influencing factors.

Results

21 patients (4.8 %) developed heterotopic ossifications, all located in the area of the distal femur. The only risk factor found concerning the development of HO was osteoarthritis when compared to rheumatoid arthritis (OR = 4.07, 95 % CI 1.18–14.05; p = 0.0201) and postoperative wound healing problems (OR = 11.32, 95 % CI 3.26–39.33; p = 0.0001). Notching (OR = 2.22, 95 % CI 0.92–5.36; p = 0.0765) and osteophyte forming (hypertrophic) arthrosis (OR = 2.40, 95 % CI 0.97–5.95; p = 0.0596), however, were associated with the development of a bony spur in the contact area of the femoral component of the prosthesis.

Conclusions

Our study has revealed that patients with rheumatoid arthritis are at lower risk of HO than patients with osteoarthritis. An impairment of wound healing would appear to promote the development of a HO. Notching and hypertrophic arthrosis are highly likely to be associated with the development of a bony spur in the ventral contact area of the prosthesis.

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Acknowledgements

We thank Prof. Kreitner, Institute for Radiology at the Mainz University Medical Centre for his support with radiological questions.

Conflict of interest

The author(s) declare that they have no competing interests.

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Authors and Affiliations

  1. Zentrum für Orthopädie und Unfallchirurgie, Unimedizin, Langenbeckstraße 1, 55131, Mainz, Germany

    K. E. Roth & G. S. Maier

  2. Aukammklinik für operative Orthopädie und Rheumatologie, Wiesbaden, Germany

    G. Salzmann & K. Babin

  3. Institut für Medizinische Biometrie, Epidemiologie und Informatik, Unimedizin, Mainz, Germany

    I. Schmidtmann

  4. OrthoTrauma Evaluation Institute, Mainz, Germany

    J. D. Rompe

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  1. K. E. Roth
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  2. G. Salzmann
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  3. G. S. Maier
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  4. I. Schmidtmann
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  5. J. D. Rompe
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Correspondence to K. E. Roth.

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Roth, K.E., Salzmann, G., Maier, G.S. et al. Risk factors for heterotopic ossification and spur formation after total knee arthroplasty. Arch Orthop Trauma Surg 134, 991–996 (2014). https://doi.org/10.1007/s00402-014-1957-0

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  • DOI: https://doi.org/10.1007/s00402-014-1957-0

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