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International Orthopaedics
Published in: International Orthopaedics 9/2016

01-09-2016 | Original Paper

Incidence of heterotopic ossification in direct anterior vs posterior approach to total hip arthroplasty: a retrospective radiographic review

Authors: Elizabeth A. Newman, David C. Holst, Daniel N. Bracey, Gregory B. Russell, Jason E. Lang

Published in: International Orthopaedics | Issue 9/2016

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Abstract

Purpose

To investigate the prevalence of heterotopic ossification following direct anterior approach total hip arthroplasty compared to posterior approach, performed by a single surgeon at one institution

Methods

All primary THAs performed by the senior author (JEL) over a 70-month period were reviewed, including 235 DAA and 120 posterior THAs. Brooker’s system was used to grade HO at a minimum of six months follow-up.

Results

Patients undergoing DAA were less likely to develop clinically significant HO compared to posterior THA (p = 0.04). The overall incidence of HO following DAA THA was 24.3 % (3 % grade 3 and 0 % grade 4), and following posterior THA was 27.5 % (4.2 % grade 3 and 3.3 % grade 4).

Conclusions

Lower rates of clinically significant (Brooker grade 3 and 4) HO were observed in DAA THA than in posterior approach THA. This data may be instructive when approaching THA candidates with conditions that predispose them to HO.
Literature
1.
Vastel L, Kerboull L, Anract P, Kerboull M (1998) Heterotopic ossification after total hip arthroplasty: risk factors and prevention. Rev Rhum Engl Ed 65:238–244PubMed
2.
Eggli S, Rodriguez J, Ganz R (2000) Heterotopic ossification in total hip arthroplasty: the significance for clinical outcome. Acta Orthop Belg 66:174–180PubMed
3.
Nilsson OS, Persson P (1999) Heterotopic bone formation after joint replacement. Curr Opin Rheumatol 11(2):127–131CrossRefPubMed
4.
Goel A, Sharp DJ (1991) Heterotopic bone formation after hip replacement: the influence of the type of arthritis. J Bone Joint Surg Br 73-B(2):255
5.
Zhu Y, Zhang F, Chen W, Zhang Q, Liu S, Zhang Y (2015) Incidence and risk factors for heterotopic ossification after total hip arthroplasty: a meta-analysis. Arch Orthop Trauma Surg 135:13078–1314
6.
Fahrer H, Koch P, Ballmer P, Enzler P, Gerber N (1998) Ectopic ossification following total hip arthroplasty: is diffuse idiopathic skeletal hyperostosis a risk factor? Br J Rheumatol 27:187–190CrossRef
7.
Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr (1973) Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 55(8):1629–1632PubMed
8.
Toom A, Haviko T, Rips L (2001) Heterotopic ossification after total hip arthroplasty. Int Orthop 24(6):323–326CrossRefPubMed
9.
Bergin PF, Doppelt JD, Kephart CJ et al (2011) Comparison of minimally invasive direct anterior versus posterior total hip arthroplasty based on inflammation and muscle damage markers. J Bone Joint Surg Am 93(15):1392–1398CrossRefPubMedPubMedCentral
10.
Tippets DM, Zaryanox AV, Burke WV et al (2014) Incidence of heterotopic ossification in direct anterior total hip arthroplasty: a retrospective radiographic review. J Arthroplasty 29(9):1835–1838CrossRefPubMed
11.
Bombelli R (1983) Osteoarthritis of the hip: classification and pathogenesis, 2nd edn. Springer-Verlag, BerlinCrossRef
12.
Higo T, Mawatari M, Shigematsu M, Hotokebuchi T (2006) The incidence of heteroptopic ossification after cementless total hip arthroplasty. J Arthroplasty 21:825–856CrossRef
13.
Cohn RM, Della Valle AG, Cornell CN (2010) Heterotopic ossification is less after total hip arthroplasty in patients who receive aspirin compared to Coumadin. Bull NYU Hosp Jt Dis 68(4):266PubMed
14.
Okano K, Aoyagi K, Osaki M, Motokawa S, Matsumoto T (2012) Bone mineral density is not related to heterotopic ossification after total hip arthroplasty. Int Orthop 36(6):1163–1166CrossRefPubMed
15.
Eggli S, Woo A (2001) Risk factors for heterotopic ossification in total hip arthroplasty. Arch Orthop Trauma Surg 121(9):531–535CrossRefPubMed
16.
Brunnekreef J, Hoogervorst P, Ploegmakers M, Rijnen W, Schreurs B (2013) Is etoricoxib effective in preventing heterotopic ossification after primary total hip arthroplasty? Int Orthop 37(4):583–587CrossRefPubMedPubMedCentral
17.
Xue D, Zheng Q, Li H, Qian S, Zhang B, Pan Z (2011) Selective COX-2 inhibitor versus nonselective COX-1 and COX-2 inhibitor in the prevention of heterotopic ossification after total hip arthroplasty: a meta-analysis of randomized trials. Int Orthop 35(1):3–8CrossRefPubMed
18.
Pavlou G, Salhab M, Murugesan L, Jallad S, Petsatodis G, West R, Tsiridis E (2012) Risk factors for heterotopic ossification in primary total hip arthroplasty. Hip Int 22(01):50–55CrossRefPubMed
19.
Morry BF, Adams RA, Cabanela ME (1984) Comparison of heterotopic bone after anterolateral, transtrochanteric, and posterior approaches for total hip arthroplasty. Clin Orthop 188:160–167
20.
Lugade V, Wu A, Jewett B et al (2010) Gait asymmetry following an anterior and anterolateral approach to total hip arthroplasty. Clin Biomech 25:625CrossRef
21.
Kocic M, Lazovic M, Mitkovic M et al (2010) Clinical significance of heterotopic ossification after total hip arthroplasty. Orthopedics 33(1):16CrossRefPubMed
Metadata
Title
Incidence of heterotopic ossification in direct anterior vs posterior approach to total hip arthroplasty: a retrospective radiographic review
Authors
Elizabeth A. Newman
David C. Holst
Daniel N. Bracey
Gregory B. Russell
Jason E. Lang
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 9/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-3048-4

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