Kjaersgaard-Andersen P, Schmidt S A
Biomechanics Laboratory, Orthopaedic Hospital, University of Aarhus, Denmark.
Clin Orthop Relat Res. 1991 Feb(263):78-86.
Postoperative prophylaxis with antiinflammatory medications, primarily indomethacin, is extremely effective in preventing the severest degrees of heterotopic ossification (HO) after a total hip arthroplasty (THA) and the recurrence of excised HO developed after a previous hip surgery. Prophylaxis with indomethacin should be given in 25-mg doses three times daily for at least three weeks, starting on the first postoperative morning. However, a shorter treatment period may be equally effective in preventing the severest degrees of HO, and a postoperative delay of five days before the initiation of prophylaxis does not seem to be followed by the development of severe HO. As evaluated one year after surgery, treatment with antiinflammatory medications in the immediate postoperative weeks did not increase the incidence of implant-bone interface radiolucencies, aseptic loosening, or revisions in cemented or cementless THAs when compared with cases that did not have postoperative treatment. However, although no major complications have been reported regarding the use of antiinflammatory medications in the prevention of HO after THA, orthopedic surgeons prescribing such treatment should be aware of their contraindications as well as early and late side effects. Since several antiinflammatory agents are reported to be effective in preventing HO, future reports dealing with HO after THA should always include information about the postoperative antiinflammatory treatment used.
术后使用抗炎药物（主要是吲哚美辛）进行预防，对于预防全髋关节置换术（THA）后最严重程度的异位骨化（HO）以及先前髋关节手术后切除的HO复发极为有效。吲哚美辛预防应从术后第一个早晨开始，以25毫克剂量每日三次给药，至少持续三周。然而，较短的治疗期在预防最严重程度的HO方面可能同样有效，并且术后延迟五天开始预防似乎并不会导致严重HO的发生。术后一年评估显示，与未进行术后治疗的病例相比，术后立即使用抗炎药物治疗数周并未增加骨水泥型或非骨水泥型THA中种植体-骨界面透光影、无菌性松动或翻修的发生率。然而，尽管在THA后使用抗炎药物预防HO尚未报告重大并发症，但开具此类治疗的骨科医生应了解其禁忌症以及早期和晚期副作用。由于据报道几种抗炎药物在预防HO方面有效，未来关于THA后HO的报告应始终包括所使用的术后抗炎治疗信息。
