Colin K. Cantrell, MD; Erik B. Gerlach, MD; Gregory H. Versteeg, MD; Michael D. Stover, MD; and Bennet A. Butler, MD
Heterotopic Ossiļ¬cation Prophylaxis in Acetabular Fracture Surgery: A Systematic Review
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Heterotopic ossiļ¬cation (HO) following acetabular fracture surgery is relatively common. The purpose of this study was to perform a systematic review of the literature regarding HO rates following acetabular surgery and the eļ¬ectiveness of the various prophylactic measures taken to prevent its occurrence. A search of PubMed, MEDLINE, and Cochrane Database of Systematic Reviews was performed using the search terms (āAcetabularā OR āAcetabulumā) AND (āHeterotopic Ossiļ¬cationā OR āHOā OR āEctopic Ossiļ¬cationā). Inclusion criteria included articles published in English reporting on HO in acetabular fracture surgery. Descriptive statistics were calculated with categorical data presented as frequency with percentages and continuous data as means. Standard weighted means were calculated for all parameters. Sixty-six articles were included in this study with a total of 5,028 patients. HO was identiļ¬ed in 1,511 (30%) of fractures. Indomethacin (27%) and radiation therapy (24%) demonstrated decreased rates of HO formation versus no prophylaxis (36%). In particular, rates of severe HO formation were substantially decreased with radiation therapy (3%) and indomethacin (7%) compared to no prophylaxis (18%). Indomethacin and radiation therapy both appear to decrease HO formation and severity without substantially increasing surgical morbidity. (Journal of Surgical Orthopaedic Advances 32(4):217ā224, 2023)
Key words: heterotopic ossiļ¬cation (HO), acetabular fracture, heterotopic ossiļ¬cation, prophylaxis