Heterotopic Ossification Following Arthroplasty for Femoral Neck Fracture.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Disclosure: The Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemiarthroplasty (HEALTH) trial was supported by research grants from the Canadian Institutes of Health Research (CIHR) (MCT-90168), National Institutes of Health (NIH) (1UM1AR063386-01), ZorgOnderzoek Nederland-medische wetensehappen (ZonMw) (17088.2503), Sophies Minde Foundation for Orthopaedic Research, McMaster Surgical Associates, and Stryker Orthopaedics. The funding sources had no role in design or conduct of the study; the collection, management, analysis, or interpretation of the data; or the preparation, review, or approval of the manuscript. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links.lww.com/JBJS/G429). 15. Pharm World Sci. 2003 Aug;25(4):138-45. doi: 10.1023/a:1024830213832. Prevention of heterotopic ossification after total hip replacement with NSAIDs. Fijn R(1), Koorevaar RT, Brouwers JR. Author information: (1)Groningen University Institute for Drug Exploration (GUIDE), Groningen Research Institute of Pharmacy (GRIP), Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, University of Groningen, Groningen, The Netherlands. INTRODUCTION: Non steroidal anti-inflammatory drugs (NSAIDs) and prophylactic radiotherapy can prevent ectopic bone formation around the hip after total hip arthroplasty. METHODS: We retrieved from Medline, Embase and the Cochrane Register (clinical) trials and other relevant literature on the prevention of heterotopic ossification (HO) from 1990-2002 for further review. RESULTS: Review of these clinical trials shows that HO is effectively prevented by a postoperative NSAID treatment with indomethacin for at least seven days. The best evidence is available for indomethacin, although naproxen, diclofenac and ibuprofen are also well documented. Short term use of ibuprofen is not effective. If NSAIDs are contraindicated, preoperative or postoperative radiotherapy is a very effective therapeutic option to prevent HO. DISCUSSION AND CONCLUSION: Because of the potential of serious gastrointestinal side effects of NSAIDs and their interaction with anticoagulant drugs, rofecoxib and other COX-2 specific NSAIDs may be a safer option for the treatment of HO. However, randomised controlled studies are needed to confirm the results of the rofecoxib study. DOI: 10.1023/a:1024830213832