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Clinical Orthopaedics and Related Research®

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01-06-2011 | Symposium: Update on Hard-on-Hard Bearings in Hip Arthroplasty

Aspirin Decreases Heterotopic Ossification After Hip Resurfacing

Authors: Ryan M. Nunley, MD, Jinjun Zhu, MD, PhD, John C. Clohisy, MD, Robert L. Barrack, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 6/2011

Abstract

Background

Heterotopic ossification (HO) is a concern for patients undergoing hip surgery, especially surface replacement arthroplasty (SRA) who tend to be younger, more active, and anticipate good motion. It is unclear, however, whether HO occurs more frequently after SRA than traditional total hip arthroplasty (THA) and whether aspirin influences the risk.

Questions/purposes

We therefore determined the incidence of HO after hip resurfacing compared with THA and determined whether aspirin influenced the incidence or severity of HO.

Methods

Retrospectively we compared three patient cohorts: SRA with aspirin (176 hips; 160 patients), SRA with warfarin (60 hips; 57 patients), and THA with warfarin (240 hips; 222 patients). All patients satisfied the same selection criteria and all surgeries were performed through the posterolateral approach using spinal anesthesia. HO was classified using the technique of Brooker et al. comparing the preoperative, immediate postoperative, and 6- to 12-month followup radiographs (minimum, 1 year; mean, 2.7 years).

Results

In the SRA with aspirin group, HO was detected in four of 151 hips (2.6%; two Grade I; one Grade II; one Grade III); in the SRA with warfarin group, eight of 46 hips (17.4%) had HO with four hips (8.7%) having severe HO (Grade III). All 12 patients with HO in both SRA groups were male. The HO incidence and severity was less for the SRA patients treated with aspirin compared with those treated with warfarin. In the THA with warfarin control group, HO was detected in five of 189 hips (2.6%; two Grade I; three Grade II). The HO incidence and severity were the same between the THA with warfarin and the SRA with aspirin cohorts.

Conclusions

The risk of HO is greater in SRA than in THA in patients treated with warfarin postoperatively; aspirin appears to decrease the incidence and severity of HO after hip resurfacing surgery to a similar level as total hip arthroplasty.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Title: Aspirin Decreases Heterotopic Ossification After Hip Resurfacing
Authors: Ryan M. Nunley, MD
Jinjun Zhu, MD, PhD
John C. Clohisy, MD
Robert L. Barrack, MD
Publication date: 01-06-2011
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 6/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-011-1846-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Aspirin Decreases Heterotopic Ossification After Hip Resurfacing

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

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