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    The prophylaxis and treatment of heterotopic ossification following lower limb arthroplasty

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    Authors
    Board, T N
    Karva, A
    Board, Ruth E
    Gambhir, A K
    Porter, M L
    Affiliation
    Wrightington Hospital, Wigan and the University of Manchester, Manchester, England. tim@timboard.co.uk
    Issue Date
    2007-04
    
    Metadata
    Show full item record
    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.
    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
    URI
    http://hdl.handle.net/10541/70295
    DOI
    10.1302/0301-620X.89B4.18845
    PubMed ID
    17463108
    Type
    Article
    Language
    en
    ISSN
    0301-620X
    ae974a485f413a2113503eed53cd6c53
    10.1302/0301-620X.89B4.18845
    Scopus Count
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