Skip to main content
Erschienen in: Archives of Orthopaedic and Trauma Surgery 9/2015

01.09.2015 | Hip Arthroplasty

Incidence and risk factors for heterotopic ossification after total hip arthroplasty: a meta-analysis

verfasst von: Yanbin Zhu, Fei Zhang, Wei Chen, Qi Zhang, Song Liu, Yingze Zhang

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 9/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

This study aims to quantitatively summarize risk factors associated with heterotopic ossification after total hip arthroplasty.

Methods

The computerized and additional manual searches were performed in Medline, Embase, CNKI, and Cochrane central database (all through March 2014) for potential studies. Studies eligible had to meet the quality assessment criteria by Newcastle–Ottawa Scale and to evaluate the risk factors for heterotopic ossification after total hip arthroplasty. Two reviewers independently extracted the relevant data and any disagreement was solved by consensus. Stata11.0 was used to perform all the statistical analyses.

Results

Fourteen studies involving 6468 cases with total hip arthroplasty and 1939 heterotopic ossification (HOs) (30.0 %) were eligible and included in this meta-analysis. Our meta-analysis identified the significant increased risk factors for HO were male gender [odds ratio (OR) 2.11; 95 % confidence interval (CI) 1.80–2.48)], cemented implant (OR 1.48; 95 % CI 1.00–2.17), bilateral operations (OR 1.74; 95 % CI 1.24–2.45), ankylosing spondylitis (OR 1.90; 95 % CI 1.07–3.37) and ankylosed hip (OR 9.85; 95 % CI 2.61–37.24). Rheumatoid arthritis was protective for the development of HO (OR 0.51; 95 % CI 0.33–0.80). The other variables including age, use of NSAIDs, femoral neck fracture, previous hip fracture, hypertrophic osteoarthritis and osteophytes were identified not as the risk factors for development of HO (P > 0.05).

Conclusion

Patients involved with the above-mentioned medical conditions should be carefully paid close attention by surgeons to reduce HO after total hip arthroplasty.

Level of evidence

Level II, meta-analysis.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Board T, Karva A, Board RE et al (2007) The prophylaxis and treatment of heterotopic ossification following lower limb arthroplasty. J Bone Jt Surg Br 89(4):434–440CrossRef Board T, Karva A, Board RE et al (2007) The prophylaxis and treatment of heterotopic ossification following lower limb arthroplasty. J Bone Jt Surg Br 89(4):434–440CrossRef
2.
Zurück zum Zitat Balboni TA, Gobezie R, Mamon HJ (2006) Heterotopic ossification: pathophysiology, clinical features, and the role of radiotherapy for prophylaxis. Int J Radiat Oncol Biol Phys 65(5):1289–1299CrossRefPubMed Balboni TA, Gobezie R, Mamon HJ (2006) Heterotopic ossification: pathophysiology, clinical features, and the role of radiotherapy for prophylaxis. Int J Radiat Oncol Biol Phys 65(5):1289–1299CrossRefPubMed
3.
Zurück zum Zitat Chao ST, Lee S-Y, Borden LS et al (2006) External beam radiation helps prevent heterotopic bone formation in patients with a history of heterotopic ossification. J Arthroplast 21(5):731–736CrossRef Chao ST, Lee S-Y, Borden LS et al (2006) External beam radiation helps prevent heterotopic bone formation in patients with a history of heterotopic ossification. J Arthroplast 21(5):731–736CrossRef
4.
Zurück zum Zitat Amstutz HC, Fowble VA, Schmalzried TP et al (1997) Short-course indomethacin prevents heterotopic ossification in a high-risk population following total hip arthroplasty. J Arthroplast 12(2):126–132CrossRef Amstutz HC, Fowble VA, Schmalzried TP et al (1997) Short-course indomethacin prevents heterotopic ossification in a high-risk population following total hip arthroplasty. J Arthroplast 12(2):126–132CrossRef
5.
Zurück zum Zitat Eggli S, Woo A (2001) Risk factors for heterotopic ossification in total hip arthroplasty. Arch Orthop Trauma Surg 121(9):531–535CrossRefPubMed Eggli S, Woo A (2001) Risk factors for heterotopic ossification in total hip arthroplasty. Arch Orthop Trauma Surg 121(9):531–535CrossRefPubMed
6.
Zurück zum Zitat Eggli S, Rodriguez J, Ganz R (2000) Heterotopic ossification in total hip arthroplasty: the significance for clinical outcome. Acta Orthop Belg 66(2):174–180PubMed Eggli S, Rodriguez J, Ganz R (2000) Heterotopic ossification in total hip arthroplasty: the significance for clinical outcome. Acta Orthop Belg 66(2):174–180PubMed
7.
Zurück zum Zitat Higo T, Mawatari M, Shigematsu M et al (2006) The incidence of heterotopic ossification after cementless total hip arthroplasty. J Arthroplast 21(6):852–856CrossRef Higo T, Mawatari M, Shigematsu M et al (2006) The incidence of heterotopic ossification after cementless total hip arthroplasty. J Arthroplast 21(6):852–856CrossRef
8.
Zurück zum Zitat Iorio R, Healy WL (2002) Heterotopic ossification after hip and knee arthroplasty: risk factors, prevention, and treatment. J Am Acad Orthop Surg 10(6):409–416PubMed Iorio R, Healy WL (2002) Heterotopic ossification after hip and knee arthroplasty: risk factors, prevention, and treatment. J Am Acad Orthop Surg 10(6):409–416PubMed
9.
Zurück zum Zitat Hamid N, Ashraf N, Bosse MJ et al (2010) Radiation therapy for heterotopic ossification prophylaxis acutely after elbow trauma prospective randomized study. J Bone Jt Surg Am 92(11):2032–2038CrossRef Hamid N, Ashraf N, Bosse MJ et al (2010) Radiation therapy for heterotopic ossification prophylaxis acutely after elbow trauma prospective randomized study. J Bone Jt Surg Am 92(11):2032–2038CrossRef
10.
Zurück zum Zitat Mishra MV, Austin L, Parvizi J et al (2011) Safety and efficacy of radiation therapy as secondary prophylaxis for heterotopic ossification of non-hip joints. J Med Imaging Radiat Oncol 55(3):333–336CrossRefPubMed Mishra MV, Austin L, Parvizi J et al (2011) Safety and efficacy of radiation therapy as secondary prophylaxis for heterotopic ossification of non-hip joints. J Med Imaging Radiat Oncol 55(3):333–336CrossRefPubMed
11.
Zurück zum Zitat Pedersen N, Kristensen S, Schmidt S et al (1989) Factors associated with heterotopic bone formation following total hip replacement. Arch Orthop Trauma Surg 108(2):92–95CrossRefPubMed Pedersen N, Kristensen S, Schmidt S et al (1989) Factors associated with heterotopic bone formation following total hip replacement. Arch Orthop Trauma Surg 108(2):92–95CrossRefPubMed
12.
Zurück zum Zitat Ritter MA, Vaughan RB (1977) Ectopic ossificationaftertotalhip arthroplasty. Predisposing factors, frequency, and effect on results. J Bone Jt Surg Am 59(3):345–351 Ritter MA, Vaughan RB (1977) Ectopic ossificationaftertotalhip arthroplasty. Predisposing factors, frequency, and effect on results. J Bone Jt Surg Am 59(3):345–351
13.
Zurück zum Zitat Koelbl O, Seufert J, Pohl F et al (2003) Preoperative irradiation for prevention of heterotopic ossification following prosthetic total hip replacement. Strahlenther Onkol 179(11):767–773CrossRefPubMed Koelbl O, Seufert J, Pohl F et al (2003) Preoperative irradiation for prevention of heterotopic ossification following prosthetic total hip replacement. Strahlenther Onkol 179(11):767–773CrossRefPubMed
14.
Zurück zum Zitat Pavlou G, Salhab M, Jallad S et al (2012) Risk factors for heterotopic ossification in primary total hip arthroplasty. Hip Int 22(1):50–55CrossRefPubMed Pavlou G, Salhab M, Jallad S et al (2012) Risk factors for heterotopic ossification in primary total hip arthroplasty. Hip Int 22(1):50–55CrossRefPubMed
15.
Zurück zum Zitat Nayak K, Mulliken B, Rorabeck C et al (1997) Prevalence of heterotopic ossification in cemented versus noncemented total hip joint replacement in patients with osteoarthrosis: a randomized clinical trial. Can J Surg 40(5):368–374PubMedCentralPubMed Nayak K, Mulliken B, Rorabeck C et al (1997) Prevalence of heterotopic ossification in cemented versus noncemented total hip joint replacement in patients with osteoarthrosis: a randomized clinical trial. Can J Surg 40(5):368–374PubMedCentralPubMed
16.
Zurück zum Zitat Lieberman I, Moran E, Hastings D et al (1994) Heterotopic ossification after primary cemented and noncemented total hip arthroplasty in patients with osteoarthritis and rheumatoid arthritis. Can J Surg 37(2):135–139PubMed Lieberman I, Moran E, Hastings D et al (1994) Heterotopic ossification after primary cemented and noncemented total hip arthroplasty in patients with osteoarthritis and rheumatoid arthritis. Can J Surg 37(2):135–139PubMed
17.
Zurück zum Zitat Maloney W, Krushell R, Jasty M et al (1991) Incidence of heterotopic ossification after total hip replacement: effect of the type of fixation of the femoral component. J Bone Jt Surg Am 73(2):191–193 Maloney W, Krushell R, Jasty M et al (1991) Incidence of heterotopic ossification after total hip replacement: effect of the type of fixation of the femoral component. J Bone Jt Surg Am 73(2):191–193
18.
Zurück zum Zitat Kocic M, Lazovic M, Mitkovic M et al (2010) Clinical significance of the heterotopic ossification after total hip arthroplasty. Orthopedics 33(1):16CrossRefPubMed Kocic M, Lazovic M, Mitkovic M et al (2010) Clinical significance of the heterotopic ossification after total hip arthroplasty. Orthopedics 33(1):16CrossRefPubMed
19.
Zurück zum Zitat Purtill JJ, Eng K, Rothman RH et al (1996) Heterotopic ossification: incidence in cemented versus cementless total hip arthroplasty. J Arthroplast 11(1):58–63CrossRef Purtill JJ, Eng K, Rothman RH et al (1996) Heterotopic ossification: incidence in cemented versus cementless total hip arthroplasty. J Arthroplast 11(1):58–63CrossRef
20.
Zurück zum Zitat Zeckey C, Hildebrand F, Frink M et al (2011) Heterotopic ossifications following implant surgery—epidemiology, therapeutical approaches and current concepts. Semin Immunopathol 33(3):273–286CrossRefPubMed Zeckey C, Hildebrand F, Frink M et al (2011) Heterotopic ossifications following implant surgery—epidemiology, therapeutical approaches and current concepts. Semin Immunopathol 33(3):273–286CrossRefPubMed
21.
Zurück zum Zitat Ahrengart L (1991) Periarticular heterotopic ossification after total hip arthroplasty: risk factors and consequences. Clin Orthop Relat Res 263:49–58PubMed Ahrengart L (1991) Periarticular heterotopic ossification after total hip arthroplasty: risk factors and consequences. Clin Orthop Relat Res 263:49–58PubMed
22.
Zurück zum Zitat Wells G, Shea B, O’connell D et al (2000) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses Wells G, Shea B, O’connell D et al (2000) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses
23.
Zurück zum Zitat Lau J, Ioannidis JP, Schmid CH (1997) Quantitative synthesis in systematic reviews. Ann Intern Med 127(9):820–826CrossRefPubMed Lau J, Ioannidis JP, Schmid CH (1997) Quantitative synthesis in systematic reviews. Ann Intern Med 127(9):820–826CrossRefPubMed
24.
Zurück zum Zitat Wei J, Yang T-B, Luo W et al (2013) Complications following dorsal versus volar plate fixation of distal radius fracture: a meta-analysis. J Int Med Res 41(2):265–275CrossRefPubMed Wei J, Yang T-B, Luo W et al (2013) Complications following dorsal versus volar plate fixation of distal radius fracture: a meta-analysis. J Int Med Res 41(2):265–275CrossRefPubMed
25.
Zurück zum Zitat Drake MT, Murad MH, Mauck KF et al (2012) Risk factors for low bone mass-related fractures in men: a systematic review and meta-analysis. J Clin Endocrinol Metab 97(6):1861–1870CrossRefPubMed Drake MT, Murad MH, Mauck KF et al (2012) Risk factors for low bone mass-related fractures in men: a systematic review and meta-analysis. J Clin Endocrinol Metab 97(6):1861–1870CrossRefPubMed
26.
Zurück zum Zitat Chen J, Cui Y, Li X et al (2013) Risk factors for deep infection after total knee arthroplasty: a meta-analysis. Arch Orthop Trauma Surg 133(5):675–687CrossRefPubMed Chen J, Cui Y, Li X et al (2013) Risk factors for deep infection after total knee arthroplasty: a meta-analysis. Arch Orthop Trauma Surg 133(5):675–687CrossRefPubMed
27.
Zurück zum Zitat Fahrer H, Koch P, Ballmer P et al (1988) Ectopic ossification following total hip arthroplasty: is diffuse idiopathic skeletal hyperostosis a risk factor? Br J Rheumatol 27(3):187–190CrossRefPubMed Fahrer H, Koch P, Ballmer P et al (1988) Ectopic ossification following total hip arthroplasty: is diffuse idiopathic skeletal hyperostosis a risk factor? Br J Rheumatol 27(3):187–190CrossRefPubMed
28.
Zurück zum Zitat Fransen M, Neal B, Cameron ID et al (2009) Determinants of heterotopic ossification after total hip replacement surgery. Hip Int 19(1):41–46PubMed Fransen M, Neal B, Cameron ID et al (2009) Determinants of heterotopic ossification after total hip replacement surgery. Hip Int 19(1):41–46PubMed
29.
Zurück zum Zitat Okano K, Aoyagi K, Osaki M et al (2012) Bone mineral density is not related to heterotopic ossification after total hip arthroplasty. Int Orthop 36(6):1163–1166PubMedCentralCrossRefPubMed Okano K, Aoyagi K, Osaki M et al (2012) Bone mineral density is not related to heterotopic ossification after total hip arthroplasty. Int Orthop 36(6):1163–1166PubMedCentralCrossRefPubMed
30.
Zurück zum Zitat Handel M, Brettschneider J, Köck F et al (2003) Risk factors associated with heterotopic ossifications in primary total hip arthroplasty. Z Orthop Ihre Grenzgeb 142(5):564–570CrossRef Handel M, Brettschneider J, Köck F et al (2003) Risk factors associated with heterotopic ossifications in primary total hip arthroplasty. Z Orthop Ihre Grenzgeb 142(5):564–570CrossRef
31.
Zurück zum Zitat Nollen AJ, van Douveren FQ (1993) Ectopic ossification in hip arthroplasty: a retrospective study of predisposing factors in 637 cases. Acta Orthop Scand 64(2):185–187CrossRefPubMed Nollen AJ, van Douveren FQ (1993) Ectopic ossification in hip arthroplasty: a retrospective study of predisposing factors in 637 cases. Acta Orthop Scand 64(2):185–187CrossRefPubMed
32.
Zurück zum Zitat Wu L, Wu F, Ye K et al (2007) Heterotopic ossification following primary total hip arthroplasty. Chin J Ortho 27(12):910–914 Wu L, Wu F, Ye K et al (2007) Heterotopic ossification following primary total hip arthroplasty. Chin J Ortho 27(12):910–914
33.
Zurück zum Zitat Wang Z, Zhou J, Li Z et al (2012) Clinical study on heterotopic ossification after the operation of total hiparthroplasty and revision. Ana Clin 17(003):220–223 Wang Z, Zhou J, Li Z et al (2012) Clinical study on heterotopic ossification after the operation of total hiparthroplasty and revision. Ana Clin 17(003):220–223
34.
Zurück zum Zitat Hierton C, Blomgren G, Lindgren U (1983) Factors associated with heterotopic bone formation in cemented total hip prostheses. Acta Orthop Scand 54(5):698–702CrossRefPubMed Hierton C, Blomgren G, Lindgren U (1983) Factors associated with heterotopic bone formation in cemented total hip prostheses. Acta Orthop Scand 54(5):698–702CrossRefPubMed
35.
Zurück zum Zitat Hastings H 2nd, Graham TJ (1994) The classification and treatment of heterotopic ossification about the elbow and forearm. Hand Clin 10(3):417–437PubMed Hastings H 2nd, Graham TJ (1994) The classification and treatment of heterotopic ossification about the elbow and forearm. Hand Clin 10(3):417–437PubMed
36.
Zurück zum Zitat Schmidmaier G, Herrmann S, Green J et al (2006) Quantitative assessment of growth factors in reaming aspirate, iliac crest, and platelet preparation. Bone 39(5):1156–1163CrossRefPubMed Schmidmaier G, Herrmann S, Green J et al (2006) Quantitative assessment of growth factors in reaming aspirate, iliac crest, and platelet preparation. Bone 39(5):1156–1163CrossRefPubMed
Metadaten
Titel
Incidence and risk factors for heterotopic ossification after total hip arthroplasty: a meta-analysis
verfasst von
Yanbin Zhu
Fei Zhang
Wei Chen
Qi Zhang
Song Liu
Yingze Zhang
Publikationsdatum
01.09.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 9/2015
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-015-2277-8

Weitere Artikel der Ausgabe 9/2015

Archives of Orthopaedic and Trauma Surgery 9/2015 Zur Ausgabe

Abstracts

Abstracts

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Lever-Sign-Test hilft beim Verdacht auf Kreuzbandriss

15.05.2024 Vordere Kreuzbandruptur Nachrichten

Mit dem Hebelzeichen-Test lässt sich offenbar recht zuverlässig feststellen, ob ein vorderes Kreuzband gerissen ist. In einer Metaanalyse war die Vorhersagekraft vor allem bei positivem Testergebnis hoch.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.