Eggli S, Rodriguez J, Ganz R
Department of Orthopedic Surgery, University of Berne, Inselspital, Switzerland.
Acta Orthop Belg. 2000 Apr;66(2):174-80.
This study evaluates 706 patients with 835 primary total hip replacements documented in a prospective fashion in a multicenter study with respect to correlation between heterotopic ossification (HO) and clinical outcome. Only patients without prophylaxis against HO entered the study. The mean clinical and radiological follow-up was 3.1 years (+/- 0.7). Heterotopic ossification was noted in 47% of all total hips replaced. It was graded as mild (Brooker I) in 29.1%, moderate (Brooker II) in 12.7%, and severe (Brooker III and IV) in 5.2%. All clinical parameters investigated were significantly affected with the increasing amount of heterotopic ossification. The strongest correlation was found in flexion range and spreading distance. Both factors were significantly decreased with higher degrees of ossification. The other clinical parameters investigated, walking capacity, limp, and use of analgesics, were altered to a lesser extent and only with higher degrees of heterotopic bone formation. Finally, patient satisfaction was significantly influenced by the degree of heterotopic ossification and dropped from almost 90% good or excellent patient satisfaction in the non-ossification group to less than 30% in the group with severe ossification.
本研究在一项多中心研究中以前瞻性方式评估了706例患者的835例初次全髋关节置换术，探讨异位骨化（HO）与临床结局之间的相关性。仅未接受HO预防的患者进入本研究。临床和影像学的平均随访时间为3.1年（±0.7）。在所有接受置换的全髋关节中，47%出现了异位骨化。其中，轻度（布鲁克I级）占29.1%，中度（布鲁克II级）占12.7%，重度（布鲁克III级和IV级）占5.2%。所有研究的临床参数均随着异位骨化量的增加而受到显著影响。在屈曲范围和外展距离方面发现了最强的相关性。随着骨化程度的增加，这两个因素均显著降低。其他研究的临床参数，如行走能力、跛行和镇痛药的使用，变化程度较小，且仅在异位骨化程度较高时出现。最后，患者满意度受异位骨化程度的显著影响，在无骨化组中，患者满意度几乎为90%为良好或优秀，而在重度骨化组中则降至不到30%。
