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Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort

Background: Heterotopic ossification (HO) is a well-known complication of arthroscopic and open surgical treatment of femoroacetabular impingement (FAI). Incidence of heterotopic ossification has been reported in the literature between 0% and 44% after hip arthroscopy and between 18.2% and 25% after...

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Autores principales: Olivero, Matteo, Capurro, Bruno, Reis-Campos, Pedro, Aprato, Alessandro, Ayeni, Olufemi, Chawla, Anuj, Larrainzar Garijo, Ricardo, Marín-Peña, Oliver
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDP Sciences 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10478760/
https://www.ncbi.nlm.nih.gov/pubmed/37668540
http://dx.doi.org/10.1051/sicotj/2023024
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author Olivero, Matteo
Capurro, Bruno
Reis-Campos, Pedro
Aprato, Alessandro
Ayeni, Olufemi
Chawla, Anuj
Larrainzar Garijo, Ricardo
Marín-Peña, Oliver
author_facet Olivero, Matteo
Capurro, Bruno
Reis-Campos, Pedro
Aprato, Alessandro
Ayeni, Olufemi
Chawla, Anuj
Larrainzar Garijo, Ricardo
Marín-Peña, Oliver
author_sort Olivero, Matteo
collection PubMed
description Background: Heterotopic ossification (HO) is a well-known complication of arthroscopic and open surgical treatment of femoroacetabular impingement (FAI). Incidence of heterotopic ossification has been reported in the literature between 0% and 44% after hip arthroscopy and between 18.2% and 25% after anterior mini-open surgery. Currently, pharmacological prophylaxis with NSAIDs and selective COX-2 inhibitors are commonly used and their effectiveness is well documented in literature. Hypothesis: We hypothesized that the low-dose prophylaxis protocol with selective cox-2 inhibitors decreases the risk of heterotopic ossification in open or arthroscopic hip preservation surgery in athletes. Methods: This study is an analysis of prospectively gathered data on 98 sport participant patients who underwent arthroscopic or anterior mini-open treatment for FAI between April 2008 and April 2018. All the patients received postoperative oral prophylaxis with 60 mg etoricoxib once daily for two weeks. Post-operative X-rays were performed at 1, 3, and 12 months after surgery and reviewed by two orthopedic surgeons blinded to the type and side of surgery. HO were graded according to the Brooker classification. Descriptive statistics was used to analyze demographic data. Bivariate analysis was performed to analyze the association of HO with each of the following variables: type of surgery, physical activity, time of evolution of symptoms, age at surgery, and sex. Finally, a regression model analysis was performed to determine the presence of confounding effects between variables. Results: The study cohort was composed of 54 patients in the arthroscopic treatment group and 44 patients in the anterior mini-open group. HO was identified in 6 (13.6%) patients in the mini-open group. No HO was identified in the arthroscopic group. In the bivariate analysis, “type of surgery” was the only variable that showed a statistically significant association with HO (p = 0.007). Conclusion: Results of this study suggest that anterior mini-open treatment was characterized by a higher risk of HO development compared to hip arthroscopy for femoroacetabular impingement treatment regardless of pharmacological prophylaxis. The treatment regimen of 60 mg etoricoxib daily for two weeks was an effective prophylaxis for HO formation in sport participant patients compared with data available in the literature.
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spelling pubmed-104787602023-09-06 Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort Olivero, Matteo Capurro, Bruno Reis-Campos, Pedro Aprato, Alessandro Ayeni, Olufemi Chawla, Anuj Larrainzar Garijo, Ricardo Marín-Peña, Oliver SICOT J Original Article Background: Heterotopic ossification (HO) is a well-known complication of arthroscopic and open surgical treatment of femoroacetabular impingement (FAI). Incidence of heterotopic ossification has been reported in the literature between 0% and 44% after hip arthroscopy and between 18.2% and 25% after anterior mini-open surgery. Currently, pharmacological prophylaxis with NSAIDs and selective COX-2 inhibitors are commonly used and their effectiveness is well documented in literature. Hypothesis: We hypothesized that the low-dose prophylaxis protocol with selective cox-2 inhibitors decreases the risk of heterotopic ossification in open or arthroscopic hip preservation surgery in athletes. Methods: This study is an analysis of prospectively gathered data on 98 sport participant patients who underwent arthroscopic or anterior mini-open treatment for FAI between April 2008 and April 2018. All the patients received postoperative oral prophylaxis with 60 mg etoricoxib once daily for two weeks. Post-operative X-rays were performed at 1, 3, and 12 months after surgery and reviewed by two orthopedic surgeons blinded to the type and side of surgery. HO were graded according to the Brooker classification. Descriptive statistics was used to analyze demographic data. Bivariate analysis was performed to analyze the association of HO with each of the following variables: type of surgery, physical activity, time of evolution of symptoms, age at surgery, and sex. Finally, a regression model analysis was performed to determine the presence of confounding effects between variables. Results: The study cohort was composed of 54 patients in the arthroscopic treatment group and 44 patients in the anterior mini-open group. HO was identified in 6 (13.6%) patients in the mini-open group. No HO was identified in the arthroscopic group. In the bivariate analysis, “type of surgery” was the only variable that showed a statistically significant association with HO (p = 0.007). Conclusion: Results of this study suggest that anterior mini-open treatment was characterized by a higher risk of HO development compared to hip arthroscopy for femoroacetabular impingement treatment regardless of pharmacological prophylaxis. The treatment regimen of 60 mg etoricoxib daily for two weeks was an effective prophylaxis for HO formation in sport participant patients compared with data available in the literature. EDP Sciences 2023-09-05 /pmc/articles/PMC10478760/ /pubmed/37668540 http://dx.doi.org/10.1051/sicotj/2023024 Text en © The Authors, published by EDP Sciences, 2023 https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Olivero, Matteo
Capurro, Bruno
Reis-Campos, Pedro
Aprato, Alessandro
Ayeni, Olufemi
Chawla, Anuj
Larrainzar Garijo, Ricardo
Marín-Peña, Oliver
Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort
title Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort
title_full Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort
title_fullStr Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort
title_full_unstemmed Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort
title_short Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort
title_sort low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10478760/
https://www.ncbi.nlm.nih.gov/pubmed/37668540
http://dx.doi.org/10.1051/sicotj/2023024
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