Schauwecker J, Pohlig F, Toepfer A, Gollwitzer H, von Eisenhart-Rothe R
Klinik für Orthopädie und Unfallchirurgie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 München, Deutschland.
Orthopade. 2011 Jun;40(6):500-5. doi: 10.1007/s00132-011-1759-9.
Heterotopic ossification (HO) is a frequent and occasionally severe complication after total hip arthroplasty. Clinical symptoms of this benign abnormal bone formation are loss of mobility and local pain. The etiology and pathomechanisms are not yet completely understood. Overexpression of bone morphogenetic proteins and dysregulation of prostaglandin metabolism seem to be relevant. Medication with non-steroidal anti-inflammatory drugs (NSAIDs) and perioperative single dose radiotherapy are used for prophylaxis, whereby radiotherapy should only be performed in patients with a history of HO or additionally after resection of HO. From currently available data selective cyclooxygenase-2 inhibitors seem to have a preventive efficacy equal to the classical NSAIDs diclofenac and indometacin. This work discusses current knowledge about the pathophysiology, risk factors and the clinical approach for prevention and treatment of HO.
异位骨化（HO）是全髋关节置换术后常见且偶尔会很严重的并发症。这种良性异常骨形成的临床症状是活动受限和局部疼痛。其病因和发病机制尚未完全明确。骨形态发生蛋白的过度表达和前列腺素代谢失调似乎与之相关。使用非甾体抗炎药（NSAIDs）进行药物治疗和围手术期单次放疗用于预防，其中放疗仅应在有HO病史的患者中进行，或在HO切除术后额外进行。从目前可得的数据来看，选择性环氧化酶-2抑制剂似乎具有与经典NSAIDs双氯芬酸和吲哚美辛相当的预防效果。本文讨论了关于HO的病理生理学、危险因素以及预防和治疗的临床方法的当前知识。
