Schaver Andrew L, Willey Michael C, Westermann Robert W
Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A.
Arthrosc Sports Med Rehabil. 2021 Jul 29;3(5):e1309-e1314. doi: 10.1016/j.asmr.2021.06.001. eCollection 2021 Oct.
We evaluate the incidence of heterotopic ossification (HO) development with nonsteroidal anti-inflammatory drug (NSAID) prophylaxis in patients after open and arthroscopic hip preservation surgery.
A retrospective review identified patients who underwent hip preservation surgery at a single institution within the past 3 years. Patients who underwent hip arthroscopy with or without periacetabular osteotomy (PAO) or femoral osteotomy (FO) were included. Those who did not receive 3-month postoperative radiographs were excluded. The incidence and Brooker classification (BC) of HO in patients taking Naproxen or another NSAID (meloxicam, celecoxib, indomethacin, or aspirin alone) was assessed using AP radiographs available from 3-, 6-, and 12-month follow-up appointments. Univariate analysis was conducted to compare numerical means and categorical data (significance level = .05).
A total of 328 hips (284 patients) were included. All patients received hip arthroscopy, while 71 patients (21.6%) received concurrent periacetabular osteotomy (PAO; = 65) or femoral osteotomy (FO; = 6). Overall, 276 hips (84.4%) received Naproxen for HO prophylaxis. In total, 5 of 328 hips (1.5%) developed HO (4, BC I; 1, BC III). The rate of HO development was significantly higher in males versus females (4 of 121 (3.31%) vs 1 of 207 (.48%), = .0441). All 5 patients received arthroscopic cam resection and labral repair, and 1 patient also received PAO. Three patients in the Naproxen group (.91%) developed HO, which was not statistically different from those taking a different NSAID (.61%, = .1797).
The incidence of HO development was low with NSAID prophylaxis after hip preservation surgery.
我们评估在开放性和关节镜下髋关节保留手术后使用非甾体抗炎药(NSAID)预防异位骨化(HO)的发生率。
一项回顾性研究确定了过去3年内于单一机构接受髋关节保留手术的患者。纳入接受髋关节镜检查(无论是否同时进行髋臼周围截骨术(PAO)或股骨截骨术(FO))的患者。未接受术后3个月X线片检查的患者被排除。使用3个月、6个月和12个月随访预约时获得的前后位X线片评估服用萘普生或其他NSAID(美洛昔康、塞来昔布、吲哚美辛或仅阿司匹林)的患者中HO的发生率和布鲁克分类(BC)。进行单因素分析以比较数值均值和分类数据(显著性水平=0.05)。
共纳入328髋(284例患者)。所有患者均接受了髋关节镜检查,而71例患者(21.6%)同时接受了髋臼周围截骨术(PAO;n=65)或股骨截骨术(FO;n=6)。总体而言,276髋(84.4%)接受萘普生预防HO。总共328髋中有5髋(1.5%)发生HO(4例为BC I;1例为BC III)。男性HO发生率显著高于女性(121例中的4例(3.31%)对207例中的1例(0.48%),P=0.0441)。所有5例患者均接受了关节镜下凸轮切除术和盂唇修复,1例患者还接受了PAO。萘普生组3例患者(0.91%)发生HO,与服用其他NSAID的患者(0.61%)无统计学差异(P=0.1797)。
髋关节保留手术后使用NSAID预防HO的发生率较低。