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抗炎预防可防止对侧髋关节镜检查中异位骨化：一例报告

Anti-inflammatory Prophylaxis Prevents Heterotopic Ossification in Contralateral Side Hip Arthroscopy: A Case Report.

作者信息

Warschawski Yaniv, Sharfman Zachary T, Amar Eyal, Rath Ehud

机构信息

Department of Orthopaedics, Tel-Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

J Orthop Case Rep. 2017 Jan-Feb;7(1):20-23. doi: 10.13107/jocr.2250-0685.670.

DOI:10.13107/jocr.2250-0685.670
PMID:28630833
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5458690/
Abstract

INTRODUCTION

Heterotopic ossification (HO) after hip surgery is the formation of bone in non-skeletal tissue, usually between the muscle and the joint capsule. HO after hip surgery may be associated with clinical sequelae such as pain, impingement and decreased range of motion, compromising surgical outcomes.

CASE REPORT

A 20-year-old basketball player presented with a 2-year duration of the left groin pain after a basketball-related injury. Due to continued disability and failure of conservative management the patient underwent hip arthroscopy. No HO prophylaxis was given. Follow-up radiographs at 3 months after left hip arthroscopy showed Grade 3 HO on the left side. On the 2 post-operative visit, the patient complained of contralateral (right-sided) hip pain. Due to continued symptoms on the right side and failure to respond to conservative management the patient underwent right hip arthroscopy. HO prophylaxis was initiated with non-steroidal anti-inflammatory medications (NSAIDs) treatment (Etodolac) 600 mg/day for 14 days. Follow-up radiographs at 3 months after the right hip arthroscopy showed no HO.

CONCLUSION

This case demonstrates the efficacy of HO prophylaxis in a single patient. Routine HO prophylaxis with NSAIDs should be considered for patients undergoing hip arthroscopy with osteoplasty. A minimum of 9 weeks post-operative follow-up is recommended to assess the radiographic presence of HO.

摘要

引言

髋关节手术后的异位骨化（HO）是指在非骨骼组织中形成骨，通常位于肌肉和关节囊之间。髋关节手术后的HO可能与疼痛、撞击和活动范围减小等临床后遗症相关，从而影响手术效果。

病例报告

一名20岁的篮球运动员在一次与篮球相关的受伤后，左侧腹股沟疼痛持续了2年。由于持续残疾且保守治疗无效，该患者接受了髋关节镜检查。未进行HO预防。左侧髋关节镜检查后3个月的随访X线片显示左侧为3级HO。在术后第二次就诊时，患者主诉对侧（右侧）髋关节疼痛。由于右侧症状持续且对保守治疗无反应，该患者接受了右侧髋关节镜检查。开始使用非甾体抗炎药（NSAIDs）（依托度酸）600毫克/天进行HO预防治疗，持续14天。右侧髋关节镜检查后3个月的随访X线片显示无HO。

结论

本病例证明了HO预防对单一患者的有效性。对于接受髋关节镜下骨成形术的患者，应考虑常规使用NSAIDs进行HO预防。建议术后至少随访9周以评估HO的影像学表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad2c/5458690/040bddee2958/JOCR-7-20-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad2c/5458690/d032a0f495ab/JOCR-7-20-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad2c/5458690/69e8cf65e2f2/JOCR-7-20-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad2c/5458690/19dc464fb639/JOCR-7-20-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad2c/5458690/72f5029b2dc9/JOCR-7-20-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad2c/5458690/040bddee2958/JOCR-7-20-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad2c/5458690/d032a0f495ab/JOCR-7-20-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad2c/5458690/69e8cf65e2f2/JOCR-7-20-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad2c/5458690/19dc464fb639/JOCR-7-20-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad2c/5458690/72f5029b2dc9/JOCR-7-20-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad2c/5458690/040bddee2958/JOCR-7-20-g005.jpg

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