Total Hip Arthroplasty for Patients Who Have Ankylosing Spondylitis: Is Postoperative Irradiation Required for Prophylaxis of Heterotopic Ossification?

Hung-Kai Weng; Po-Kuei Wu; Cheng-Fong Chen; Lien-Hsiang Chung; Chien-Lin Liu; Tain-Hsiung Chen; Wei-Ming Chen

doi:10.1016/j.arth.2015.04.022

Total Hip Arthroplasty for Patients Who Have Ankylosing Spondylitis: Is Postoperative Irradiation Required for Prophylaxis of Heterotopic Ossification?

J Arthroplasty. 2015 Oct;30(10):1752-6. doi: 10.1016/j.arth.2015.04.022. Epub 2015 Apr 24.

Authors

Hung-Kai Weng¹, Po-Kuei Wu², Cheng-Fong Chen¹, Lien-Hsiang Chung³, Chien-Lin Liu¹, Tain-Hsiung Chen¹, Wei-Ming Chen¹

Affiliations

¹ Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopaedic, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
² Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopaedic, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
³ Department of Orthopaedic, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Division of Orthopaedic Oncology, Department of Orthopaedics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan, ROC.

PMID: 25980776
DOI: 10.1016/j.arth.2015.04.022

Abstract

Postoperative radiation for prevention of heterotopic ossification (HO) has been proven effective for the patients with ankylosing spondylitis (AS) after total hip arthroplasties (THA). This study aims to evaluate the effect of postoperative radiation in HO formation following THA in patients with AS. We retrospectively reviewed 129 hips from 91 patients with AS receiving primary THA from July 2004 to December 2012. There were total 38 patients (53 hips) did not receive postoperative prophylaxis in Group I. Moreover, 53 patients (76 hips) received postoperative single-fraction radiotherapy of 500 cGy in Group II. After a minimum 12-month follow-up, there was no significant difference in HO formation between the two groups (P=0.210). This study suggests that postoperative radiation may not be necessary in Asian patients.

Keywords: ankylosing spondylitis; heterotopic ossification; postoperative radiation; prophylactic irradiation; total hip arthroplasty.

MeSH terms

Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip*
Asian People
Female
Hip Joint / radiation effects
Hip Prosthesis
Humans
Male
Middle Aged
Ossification, Heterotopic / prevention & control*
Ossification, Heterotopic / radiotherapy
Postoperative Care*
Postoperative Complications / prevention & control*
Postoperative Period
Retrospective Studies
Spondylitis, Ankylosing / surgery*