Skip to main content
Top
Published in: Journal of Orthopaedics and Traumatology 4/2010

Open Access 01-12-2010 | Brief Communication

Heterotopic ossifications after arthroscopic management of femoroacetabular impingement: the role of NSAID prophylaxis

Authors: Filippo Randelli, Luca Pierannunzii, Lorenzo Banci, Vincenza Ragone, Alberto Aliprandi, Robert Buly

Published in: Journal of Orthopaedics and Traumatology | Issue 4/2010

Login to get access

Abstract

Background

Open hip surgery is known to be a risk for heterotopic ossification (HO), and nonsteroidal anti-inflammatory drugs (NSAIDs) have been widely recognized as an effective prevention. Hip arthroscopy is gaining popularity thanks to the possibility of treating femoroacetabular impingement (FAI) with a minimally invasive technique, however little is known about its rate of postoperative HO. The aim of the present study is to evaluate HO prevalence after hip arthroscopy for FAI and its relationship with NSAID prophylaxis.

Materials and methods

We retrospectively reviewed 300 FAI cases who have been managed with hip arthroscopy in two different hospitals from April 2006 to May 2009. All medical records and indications at discharge were analyzed, focusing on administration of NSAIDs, as well as follow-up roentgenograms with regard to presence of HO around the hip joint. The patients were divided into two groups: a treatment group of 285 hips which received NSAID prophylaxis and a control group of 15 hips which did not.

Results

Five hips presented HO, with overall prevalence of 1.6%. All five patients with HO belonged to the control group. No HO was observed in the treatment group. Thus, HO rate turned out to be significantly higher (P < 0.001) in patients who did not receive NSAIDs after surgery.

Conclusion

Arthroscopic treatment of FAI is not exempt from potential development of HO. NSAIDs after arthroscopic FAI treatment seem to be an effective prevention.
Literature
1.
go back to reference Neal B, Gray H, MacMahon S, Dunn L (2002) Incidence of heterotopic bone formation after major hip surgery. ANZ J Surg 72:808–821PubMedCrossRef Neal B, Gray H, MacMahon S, Dunn L (2002) Incidence of heterotopic bone formation after major hip surgery. ANZ J Surg 72:808–821PubMedCrossRef
2.
go back to reference Ritter MA, Vaughan RB (1977) Ectopic ossification after total hip arthroplasty. Predisposing factors, frequency, and effect on results. J Bone Joint Surg Am 59:345–351PubMed Ritter MA, Vaughan RB (1977) Ectopic ossification after total hip arthroplasty. Predisposing factors, frequency, and effect on results. J Bone Joint Surg Am 59:345–351PubMed
3.
go back to reference Riegler HF, Harris CM (1976) Heterotopic bone formation after total hip arthroplasty. Clin Orthop Relat Res 117:209–216PubMed Riegler HF, Harris CM (1976) Heterotopic bone formation after total hip arthroplasty. Clin Orthop Relat Res 117:209–216PubMed
4.
go back to reference Charnley J (1972) The long term results of low friction arthroplasty of the hip performed as a primary intervention. J Bone Joint Surg 54B:61–76 Charnley J (1972) The long term results of low friction arthroplasty of the hip performed as a primary intervention. J Bone Joint Surg 54B:61–76
5.
go back to reference Rosendahl S, Christoffersen K, Norgaard M (1973) Para-articular ossification after total hip replacement. Acta Orthop Scand 43:400 Rosendahl S, Christoffersen K, Norgaard M (1973) Para-articular ossification after total hip replacement. Acta Orthop Scand 43:400
6.
go back to reference Schmidt SA, Kjaersgaard-Andersen P, Pedersen NW, Kristensen SS, Pedersen P, Nielsen JB (1988) The use of indomethacin to prevent the formation of heterotopic bone after total hip replacement. A randomized, double-blind clinical trial. J Bone Joint Surg Am 70:834–838PubMed Schmidt SA, Kjaersgaard-Andersen P, Pedersen NW, Kristensen SS, Pedersen P, Nielsen JB (1988) The use of indomethacin to prevent the formation of heterotopic bone after total hip replacement. A randomized, double-blind clinical trial. J Bone Joint Surg Am 70:834–838PubMed
7.
go back to reference Pagnani MJ, Pellicci PM, Salvati EA (1991) Effect of aspirin on heterotopic ossification after total hip arthroplasty in men who have osteoarthrosis. J Bone Joint Surg Am 73:924–929PubMed Pagnani MJ, Pellicci PM, Salvati EA (1991) Effect of aspirin on heterotopic ossification after total hip arthroplasty in men who have osteoarthrosis. J Bone Joint Surg Am 73:924–929PubMed
8.
go back to reference Romano CL, Duci D, Romano D, Mazza M, Meani E (2004) Celecoxib versus indomethacin in the prevention of heterotopic ossification after total hip arthroplasty. J Arthroplasty 19(1):14–18PubMedCrossRef Romano CL, Duci D, Romano D, Mazza M, Meani E (2004) Celecoxib versus indomethacin in the prevention of heterotopic ossification after total hip arthroplasty. J Arthroplasty 19(1):14–18PubMedCrossRef
9.
go back to reference Grohs JG, Schmidt M, Wanivenhaus A (2007) Selective COX-2 inhibitor versus indomethacin for the prevention of heterotopic ossification after hip replacement: a double-blind randomized trial of 100 patients with 1-year follow-up. Acta Orthop 78(1):95–98PubMedCrossRef Grohs JG, Schmidt M, Wanivenhaus A (2007) Selective COX-2 inhibitor versus indomethacin for the prevention of heterotopic ossification after hip replacement: a double-blind randomized trial of 100 patients with 1-year follow-up. Acta Orthop 78(1):95–98PubMedCrossRef
10.
go back to reference Glick JM, Sampson TG, Gordon RB, Behr JT, Schmidt E (1987) Hip arthroscopy by the lateral approach. Arthroscopy 3:4–12PubMedCrossRef Glick JM, Sampson TG, Gordon RB, Behr JT, Schmidt E (1987) Hip arthroscopy by the lateral approach. Arthroscopy 3:4–12PubMedCrossRef
12.
go back to reference Philippon MJ, Briggs KK, Yen YM, Kuppersmith DA (2009) Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg Br 91(1):16–23PubMedCrossRef Philippon MJ, Briggs KK, Yen YM, Kuppersmith DA (2009) Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg Br 91(1):16–23PubMedCrossRef
13.
go back to reference Sampson TG (2008) Arthroscopic treatment of femoroacetabular impingement. Am J Orthop 37(12):608–612PubMed Sampson TG (2008) Arthroscopic treatment of femoroacetabular impingement. Am J Orthop 37(12):608–612PubMed
14.
go back to reference Berndt C, Ganko A, Whitehouse SL, Crawford RW (2008) Heterotopic ossification within an arthroscopic portal after uneventful partial meniscectomy. Knee 15(5):416–418PubMedCrossRef Berndt C, Ganko A, Whitehouse SL, Crawford RW (2008) Heterotopic ossification within an arthroscopic portal after uneventful partial meniscectomy. Knee 15(5):416–418PubMedCrossRef
15.
go back to reference Sodha S, Nagda SH, Sennett BJ (2006) Heterotopic ossification in a throwing athlete after elbow arthroscopy. Arthroscopy 22(7):802e1–802e3CrossRef Sodha S, Nagda SH, Sennett BJ (2006) Heterotopic ossification in a throwing athlete after elbow arthroscopy. Arthroscopy 22(7):802e1–802e3CrossRef
16.
go back to reference Boynton MD, Enders TJ (1999) Severe heterotopic ossification after arthroscopic acromioplasty: a case report. J Shoulder Elbow Surg 8(5):495–497PubMedCrossRef Boynton MD, Enders TJ (1999) Severe heterotopic ossification after arthroscopic acromioplasty: a case report. J Shoulder Elbow Surg 8(5):495–497PubMedCrossRef
17.
go back to reference Berg EE, Ciullo JV, Oglesby JW (1994) Failure of arthroscopic decompression by subacromial heterotopic ossification causing recurrent impingement. Arthroscopy 10(2):158–161PubMedCrossRef Berg EE, Ciullo JV, Oglesby JW (1994) Failure of arthroscopic decompression by subacromial heterotopic ossification causing recurrent impingement. Arthroscopy 10(2):158–161PubMedCrossRef
18.
go back to reference Larson CM, Giveans MR (2008) Arthroscopic management of femoroacetabular impingement: Early outcomes measures. Arthroscopy 24(5):540–546PubMedCrossRef Larson CM, Giveans MR (2008) Arthroscopic management of femoroacetabular impingement: Early outcomes measures. Arthroscopy 24(5):540–546PubMedCrossRef
19.
go back to reference Brooker AF, Bowerman JW, Robinson RA, Riley LH (1973) Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg 55A:1629–1632 Brooker AF, Bowerman JW, Robinson RA, Riley LH (1973) Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg 55A:1629–1632
20.
go back to reference Thomas-Byrd JW (1998) Complications associated with hip arthroscopy. In: Operative hip arthroscopy, chap 12. Thieme Medical Publisher Inc., New York, pp 171–176 Thomas-Byrd JW (1998) Complications associated with hip arthroscopy. In: Operative hip arthroscopy, chap 12. Thieme Medical Publisher Inc., New York, pp 171–176
Metadata
Title
Heterotopic ossifications after arthroscopic management of femoroacetabular impingement: the role of NSAID prophylaxis
Authors
Filippo Randelli
Luca Pierannunzii
Lorenzo Banci
Vincenza Ragone
Alberto Aliprandi
Robert Buly
Publication date
01-12-2010
Publisher
Springer International Publishing
Published in
Journal of Orthopaedics and Traumatology / Issue 4/2010
Print ISSN: 1590-9921
Electronic ISSN: 1590-9999
DOI
https://doi.org/10.1007/s10195-010-0121-z

Other articles of this Issue 4/2010

Journal of Orthopaedics and Traumatology 4/2010 Go to the issue

Acknowledgement to Referees

2010 Scientific Referees