Heterotopic Ossification Prophylaxis in Acetabular Fracture Surgery: A Systematic Review.

Colin K Cantrell, Erik B Gerlach, Gregory H Versteeg, Michael D Stover, Bennet A Butler
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Abstract

Heterotopic ossification (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 effectiveness 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 ("Acetabular" OR "Acetabulum") AND ("Heterotopic Ossification" OR "HO" OR "Ectopic Ossification"). 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 identified 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):217-224, 2023).

髋臼骨折手术中的异位骨化预防:系统回顾
髋臼骨折手术后异位骨化(HO)相对常见。本研究旨在对有关髋臼手术后异位骨化发生率以及各种预防措施的有效性的文献进行系统性回顾。我们使用检索词("髋臼 "或 "髋臼")和("异位骨化 "或 "HO "或 "异位骨化")对 PubMed、MEDLINE 和 Cochrane 系统综述数据库进行了检索。纳入标准包括以英语发表的、报道髋臼骨折手术中 HO 的文章。对分类数据进行描述性统计,以频率和百分比表示,连续数据以均值表示。所有参数均计算标准加权平均值。本研究共收录了 66 篇文章,共涉及 5,028 名患者。在 1,511 例(30%)骨折中发现了 HO。吲哚美辛(27%)和放射治疗(24%)与无预防措施(36%)相比,HO的形成率有所下降。特别是,与不采取预防措施(18%)相比,放射治疗(3%)和吲哚美辛(7%)可显著降低严重HO的形成率。吲哚美辛和放射治疗似乎都能降低 HO 的形成和严重程度,而不会大幅增加手术发病率。(外科骨科进展杂志》(Journal of Surgical Orthopaedic Advances 32(4):217-224, 2023)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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