{"title":"70 岁以下男性患者全髋关节置换术后的严重异位骨化：预防方案的有效性。","authors":"Alessandro Aprato, Simone Cambursano, Stefano Artiaco, Federico Fusini, Simone Bevilacqua, Paolo Catalani, Alessandro Massè","doi":"10.1007/s12306-024-00868-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the incidence of clinically significant heterotopic ossification (HO) in primary total hip arthroplasty (THA), comparing outcomes with and without the adoption of an HO prophylactic protocol in male patients under 70 years of age.</p><p><strong>Methods: </strong>The prophylactic protocol involved the administration of 50 mg of Indomethacin twice daily for 3 weeks. HO presence was classified according to the Brooker classification system, considering \"severe\" clinically significant HO (Brooker grade 3 and 4).</p><p><strong>Results: </strong>Two hundred and seventy-nine patients were included in our study, and an overall HO rate of 68.2% versus a rate of 61.5% was found respectively in patients not subjected and subjected to prophylactic protocol, without significant difference (PR 0.062). However, patients not subjected to the HO prophylactic protocol exhibited a severe HO rate of 22.4% compared to 7.7% in the prophylactic group, with a statistically significant difference (P = 0.008).</p><p><strong>Conclusions: </strong>Our study demonstrated that prophylactic protocol adoption is significantly associated with lower rate of severe HO in male patients under 70 years of age. Currently, there are no orthopedic guidelines for the prevention and management of HO after THA, but in the absence of contraindications, the adoption of a prophylactic protocol for HO should always be considered in high-risk patients.</p>","PeriodicalId":18875,"journal":{"name":"MUSCULOSKELETAL SURGERY","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Severe heterotopic ossification after total hip arthroplasty in male patients under 70 years of age: effectiveness of prophylactic protocol.\",\"authors\":\"Alessandro Aprato, Simone Cambursano, Stefano Artiaco, Federico Fusini, Simone Bevilacqua, Paolo Catalani, Alessandro Massè\",\"doi\":\"10.1007/s12306-024-00868-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study aims to evaluate the incidence of clinically significant heterotopic ossification (HO) in primary total hip arthroplasty (THA), comparing outcomes with and without the adoption of an HO prophylactic protocol in male patients under 70 years of age.</p><p><strong>Methods: </strong>The prophylactic protocol involved the administration of 50 mg of Indomethacin twice daily for 3 weeks. HO presence was classified according to the Brooker classification system, considering \\\"severe\\\" clinically significant HO (Brooker grade 3 and 4).</p><p><strong>Results: </strong>Two hundred and seventy-nine patients were included in our study, and an overall HO rate of 68.2% versus a rate of 61.5% was found respectively in patients not subjected and subjected to prophylactic protocol, without significant difference (PR 0.062). However, patients not subjected to the HO prophylactic protocol exhibited a severe HO rate of 22.4% compared to 7.7% in the prophylactic group, with a statistically significant difference (P = 0.008).</p><p><strong>Conclusions: </strong>Our study demonstrated that prophylactic protocol adoption is significantly associated with lower rate of severe HO in male patients under 70 years of age. Currently, there are no orthopedic guidelines for the prevention and management of HO after THA, but in the absence of contraindications, the adoption of a prophylactic protocol for HO should always be considered in high-risk patients.</p>\",\"PeriodicalId\":18875,\"journal\":{\"name\":\"MUSCULOSKELETAL SURGERY\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"MUSCULOSKELETAL SURGERY\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12306-024-00868-4\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"MUSCULOSKELETAL SURGERY","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12306-024-00868-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
背景：本研究旨在评估初次全髋关节置换术（THA）中具有临床意义的异位骨化（HO）的发生率，并比较在70岁以下男性患者中采用和不采用HO预防方案的结果：预防方案包括服用 50 毫克吲哚美辛，每天两次，持续 3 周。根据布鲁克分级系统对HO的存在进行分类，认为 "严重 "的HO具有临床意义（布鲁克3级和4级）：我们的研究共纳入了 279 名患者，发现未接受和接受预防方案治疗的患者中，HO 的总体发生率分别为 68.2%和 61.5%，差异不显著（PR 0.062）。然而，未接受 HO 预防方案治疗的患者的严重 HO 感染率为 22.4%，而接受预防方案治疗的患者的严重 HO 感染率为 7.7%，差异有统计学意义（P = 0.008）：我们的研究表明，采用预防性方案与降低 70 岁以下男性患者的严重 HO 发生率有明显关系。目前还没有关于预防和处理 THA 后 HO 的骨科指南，但在没有禁忌症的情况下，高危患者应始终考虑采用 HO 预防方案。
Severe heterotopic ossification after total hip arthroplasty in male patients under 70 years of age: effectiveness of prophylactic protocol.
Background: This study aims to evaluate the incidence of clinically significant heterotopic ossification (HO) in primary total hip arthroplasty (THA), comparing outcomes with and without the adoption of an HO prophylactic protocol in male patients under 70 years of age.
Methods: The prophylactic protocol involved the administration of 50 mg of Indomethacin twice daily for 3 weeks. HO presence was classified according to the Brooker classification system, considering "severe" clinically significant HO (Brooker grade 3 and 4).
Results: Two hundred and seventy-nine patients were included in our study, and an overall HO rate of 68.2% versus a rate of 61.5% was found respectively in patients not subjected and subjected to prophylactic protocol, without significant difference (PR 0.062). However, patients not subjected to the HO prophylactic protocol exhibited a severe HO rate of 22.4% compared to 7.7% in the prophylactic group, with a statistically significant difference (P = 0.008).
Conclusions: Our study demonstrated that prophylactic protocol adoption is significantly associated with lower rate of severe HO in male patients under 70 years of age. Currently, there are no orthopedic guidelines for the prevention and management of HO after THA, but in the absence of contraindications, the adoption of a prophylactic protocol for HO should always be considered in high-risk patients.
期刊介绍：
Musculoskeletal Surgery – Formerly La Chirurgia degli Organi di Movimento, founded in 1917 at the Istituto Ortopedico Rizzoli, is a peer-reviewed journal published three times a year. The journal provides up-to-date information to clinicians and scientists through the publication of original papers, reviews, case reports, and brief communications dealing with the pathogenesis and treatment of orthopaedic conditions.An electronic version is also available at http://www.springerlink.com.The journal is open for publication of supplements and for publishing abstracts of scientific meetings; conditions can be obtained from the Editors-in-Chief or the Publisher.
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