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Heterotopic ossification in primary total hip arthroplasty: risk factor analysis

BACKGROUND: Aim is to identify if age, sex, type of posterolateral approach (mini vs standard), surgical time and time from surgery to drainage removal were independent risk factors for heterotopic ossifications after total hip arthroplasty. MATERIALS AND METHODS: Patients who underwent a THA with p...

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Autores principales: Aprato, Alessandro, Cambursano, Simone, Artiaco, Stefano, Bevilacqua, Stefano, Catalani, Paolo, Massè, Alessandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Paris 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126050/
https://www.ncbi.nlm.nih.gov/pubmed/35377072
http://dx.doi.org/10.1007/s00590-022-03244-9
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author Aprato, Alessandro
Cambursano, Simone
Artiaco, Stefano
Bevilacqua, Stefano
Catalani, Paolo
Massè, Alessandro
author_facet Aprato, Alessandro
Cambursano, Simone
Artiaco, Stefano
Bevilacqua, Stefano
Catalani, Paolo
Massè, Alessandro
author_sort Aprato, Alessandro
collection PubMed
description BACKGROUND: Aim is to identify if age, sex, type of posterolateral approach (mini vs standard), surgical time and time from surgery to drainage removal were independent risk factors for heterotopic ossifications after total hip arthroplasty. MATERIALS AND METHODS: Patients who underwent a THA with posterolateral approach during a 15 years period were included. The exclusion criteria were absence of X-rays follow-up or HO prophylaxis protocol adoption. The following data were collected: age, sex, type of approach (classical/minimal-invasive), surgical time, time from surgery to drainage removal. Two orthopedic surgeons independently reviewed the 2 years follow-up X-rays and classified the HO according to Brooker classification. Severe HO was defined if HO were classified as major than grade 2. Correlation between severe HO and risk factor has been tested with multivariable analysis. RESULTS: About 1225 patients were included: mean age of 63.8 years, 504 were men. HO were found in 67.6%. Men showed higher severe HO rate than woman (44.1% vs 29.1%, p = 0.001). Patients older than 65 years showed higher severe HO rate (30.3% vs 39.9%, p = 0.002). Standard posterolateral approach was performed in 75.4% and severe HO rate was 32.8% versus 27.1% in those treated with the minimally invasive approach (p = 0.067). In 75.6% of cases surgery lasted less than 90 min and this group showed a severe HO rate in 29.1%, while patient with longer surgical time showed a rate of 35.7% (p = 0.033). In 47.4% of patients, the drainage was removed in the first post-operative day, in this group severe HO rate was significantly lower than the others: 24.8 versus 36.2% (p = 0.001). DISCUSSION: Male sex, age older than 65 years, surgical time longer than 90 min and delayed drainage removal are risk factors for severe HO. Patients with one or more of those risk factors should be identified as good candidates for HO prophylaxis.
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spelling pubmed-101260502023-04-26 Heterotopic ossification in primary total hip arthroplasty: risk factor analysis Aprato, Alessandro Cambursano, Simone Artiaco, Stefano Bevilacqua, Stefano Catalani, Paolo Massè, Alessandro Eur J Orthop Surg Traumatol Original Article BACKGROUND: Aim is to identify if age, sex, type of posterolateral approach (mini vs standard), surgical time and time from surgery to drainage removal were independent risk factors for heterotopic ossifications after total hip arthroplasty. MATERIALS AND METHODS: Patients who underwent a THA with posterolateral approach during a 15 years period were included. The exclusion criteria were absence of X-rays follow-up or HO prophylaxis protocol adoption. The following data were collected: age, sex, type of approach (classical/minimal-invasive), surgical time, time from surgery to drainage removal. Two orthopedic surgeons independently reviewed the 2 years follow-up X-rays and classified the HO according to Brooker classification. Severe HO was defined if HO were classified as major than grade 2. Correlation between severe HO and risk factor has been tested with multivariable analysis. RESULTS: About 1225 patients were included: mean age of 63.8 years, 504 were men. HO were found in 67.6%. Men showed higher severe HO rate than woman (44.1% vs 29.1%, p = 0.001). Patients older than 65 years showed higher severe HO rate (30.3% vs 39.9%, p = 0.002). Standard posterolateral approach was performed in 75.4% and severe HO rate was 32.8% versus 27.1% in those treated with the minimally invasive approach (p = 0.067). In 75.6% of cases surgery lasted less than 90 min and this group showed a severe HO rate in 29.1%, while patient with longer surgical time showed a rate of 35.7% (p = 0.033). In 47.4% of patients, the drainage was removed in the first post-operative day, in this group severe HO rate was significantly lower than the others: 24.8 versus 36.2% (p = 0.001). DISCUSSION: Male sex, age older than 65 years, surgical time longer than 90 min and delayed drainage removal are risk factors for severe HO. Patients with one or more of those risk factors should be identified as good candidates for HO prophylaxis. Springer Paris 2022-03-19 2023 /pmc/articles/PMC10126050/ /pubmed/35377072 http://dx.doi.org/10.1007/s00590-022-03244-9 Text en © The Author(s) 2022, corrected publication 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Aprato, Alessandro
Cambursano, Simone
Artiaco, Stefano
Bevilacqua, Stefano
Catalani, Paolo
Massè, Alessandro
Heterotopic ossification in primary total hip arthroplasty: risk factor analysis
title Heterotopic ossification in primary total hip arthroplasty: risk factor analysis
title_full Heterotopic ossification in primary total hip arthroplasty: risk factor analysis
title_fullStr Heterotopic ossification in primary total hip arthroplasty: risk factor analysis
title_full_unstemmed Heterotopic ossification in primary total hip arthroplasty: risk factor analysis
title_short Heterotopic ossification in primary total hip arthroplasty: risk factor analysis
title_sort heterotopic ossification in primary total hip arthroplasty: risk factor analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126050/
https://www.ncbi.nlm.nih.gov/pubmed/35377072
http://dx.doi.org/10.1007/s00590-022-03244-9
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