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[ 30 August 2013 ]

Indian Orthopaedic Association 57th Annual Conference 2012
[ 16 January 2013 ]

International Revision Hip Arthroplasty Symposium November 2012
[ 30 November 2012 ]

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[ 30 August 2013 ]

Tim Board
[ 30 August 2013 ]

Which factors determine the wear rate of large-diameter metal-on-metal hip replacements? Multivariate analysis of two hundred and seventy-six components.
[ 12 July 2013 ]

Medical management of osteonecrosis of the hip: a review
[ 12 July 2013 ]

New Research Published: The prophylaxis and treatment of heterotopic ossification following lower limb arthroplasty.

Board TN, Karva A, Board RE, Gambhir AK, Porter ML. The prophylaxis and treatment of heterotopic ossification following lower limb arthroplasty.

 J Bone Joint Surg Br. 2007 Apr;89(4):434-40

 

Wrightington Hospital, Wigan and the University of Manchester, Manchester, England.

link to fulltext article

Abstract

Heterotopic ossification following joint replacement in the lower limb occurs in 3% to 90% of cases. Higher grades of heterotopic ossification can result in significant limitation of function and can negate the benefits of joint replacement. The understanding of the pathophysiology of this condition has improved in recent years. It would appear to be related to a combination of systemic and local factors, including over-expression of bone morphogenetic protein-4. There is currently little evidence to support the routine use of prophylaxis for heterotopic ossification in arthroplasty patients, but prophylaxis is recommended by some for high-risk patients. Radiotherapy given as one dose of 7 Gy to 8 Gy, either pre-operatively (< four hours before) or post-operatively (within 72 hours of surgery), appears to be more effective than indometacin therapy (75 mg daily for six weeks). In cases of prophylaxis against recurrent heterotopic ossification following excision, recent work has suggested that a combination of radiotherapy and indometacin is effective. Advances in our understanding of this condition may permit the development of newer, safer treatment modalities.


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