The prophylaxis and treatment of heterotopic ossification following lower limb arthroplasty

2.50
Hdl Handle:
http://hdl.handle.net/10541/70295
Title:
The prophylaxis and treatment of heterotopic ossification following lower limb arthroplasty
Authors:
Board, T N; Karva, A; Board, Ruth E; Gambhir, A K; Porter, M L
Abstract:
Heterotopic ossification following joint replacement in the lower limb occurs in 3% to 90% of cases. Higher grades of heterotopic ossification can result in significant limitation of function and can negate the benefits of joint replacement. The understanding of the pathophysiology of this condition has improved in recent years. It would appear to be related to a combination of systemic and local factors, including over-expression of bone morphogenetic protein-4. There is currently little evidence to support the routine use of prophylaxis for heterotopic ossification in arthroplasty patients, but prophylaxis is recommended by some for high-risk patients. Radiotherapy given as one dose of 7 Gy to 8 Gy, either pre-operatively (< four hours before) or post-operatively (within 72 hours of surgery), appears to be more effective than indometacin therapy (75 mg daily for six weeks). In cases of prophylaxis against recurrent heterotopic ossification following excision, recent work has suggested that a combination of radiotherapy and indometacin is effective. Advances in our understanding of this condition may permit the development of newer, safer treatment modalities.
Affiliation:
Wrightington Hospital, Wigan and the University of Manchester, Manchester, England. tim@timboard.co.uk
Citation:
The prophylaxis and treatment of heterotopic ossification following lower limb arthroplasty. 2007, 89 (4):434-40 J Bone Joint Surg Br
Journal:
The Journal of Bone and Joint Surgery
Issue Date:
Apr-2007
URI:
http://hdl.handle.net/10541/70295
DOI:
10.1302/0301-620X.89B4.18845
PubMed ID:
17463108
Type:
Article
Language:
en
ISSN:
0301-620X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorBoard, T N-
dc.contributor.authorKarva, A-
dc.contributor.authorBoard, Ruth E-
dc.contributor.authorGambhir, A K-
dc.contributor.authorPorter, M L-
dc.date.accessioned2009-06-12T10:19:18Z-
dc.date.available2009-06-12T10:19:18Z-
dc.date.issued2007-04-
dc.identifier.citationThe prophylaxis and treatment of heterotopic ossification following lower limb arthroplasty. 2007, 89 (4):434-40 J Bone Joint Surg Bren
dc.identifier.issn0301-620X-
dc.identifier.pmid17463108-
dc.identifier.doi10.1302/0301-620X.89B4.18845-
dc.identifier.urihttp://hdl.handle.net/10541/70295-
dc.description.abstractHeterotopic ossification following joint replacement in the lower limb occurs in 3% to 90% of cases. Higher grades of heterotopic ossification can result in significant limitation of function and can negate the benefits of joint replacement. The understanding of the pathophysiology of this condition has improved in recent years. It would appear to be related to a combination of systemic and local factors, including over-expression of bone morphogenetic protein-4. There is currently little evidence to support the routine use of prophylaxis for heterotopic ossification in arthroplasty patients, but prophylaxis is recommended by some for high-risk patients. Radiotherapy given as one dose of 7 Gy to 8 Gy, either pre-operatively (< four hours before) or post-operatively (within 72 hours of surgery), appears to be more effective than indometacin therapy (75 mg daily for six weeks). In cases of prophylaxis against recurrent heterotopic ossification following excision, recent work has suggested that a combination of radiotherapy and indometacin is effective. Advances in our understanding of this condition may permit the development of newer, safer treatment modalities.en
dc.language.isoenen
dc.subject.meshAnti-Inflammatory Agents, Non-Steroidal-
dc.subject.meshArthroplasty, Replacement, Hip-
dc.subject.meshArthroplasty, Replacement, Knee-
dc.subject.meshHumans-
dc.subject.meshOssification, Heterotopic-
dc.subject.meshRisk Factors-
dc.titleThe prophylaxis and treatment of heterotopic ossification following lower limb arthroplastyen
dc.typeArticleen
dc.contributor.departmentWrightington Hospital, Wigan and the University of Manchester, Manchester, England. tim@timboard.co.uken
dc.identifier.journalThe Journal of Bone and Joint Surgeryen

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