Heterotopic Ossification Following Arthroplasty for Femoral Neck Fracture.
Arthroplasty, Replacement, Hip
/ adverse effects
Female
Femoral Neck Fractures
/ surgery
Follow-Up Studies
Humans
Male
Middle Aged
Ossification, Heterotopic
/ diagnosis
Postoperative Complications
/ diagnosis
Prevalence
Prospective Studies
Quality of Life
Randomized Controlled Trials as Topic
Reoperation
/ statistics & numerical data
Risk Factors
Severity of Illness Index
Treatment Outcome
Journal
The Journal of bone and joint surgery. American volume
ISSN: 1535-1386
Titre abrégé: J Bone Joint Surg Am
Pays: United States
ID NLM: 0014030
Informations de publication
Date de publication:
21 07 2021
21 07 2021
Historique:
pubmed:
26
3
2021
medline:
25
11
2021
entrez:
25
3
2021
Statut:
ppublish
Résumé
Heterotopic ossification (HO) is a frequent complication following hip surgery. Using data from the Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemiarthroplasty (HEALTH) trial, we aimed to (1) determine the prevalence of HO following total hip arthroplasty (THA) for femoral neck fracture in patients ≥50 years of age, (2) identify whether HO is associated with an increased risk of revision surgery within 24 months after the fracture, and (3) determine the impact of HO on functional outcomes. We performed a multivariable Cox regression analysis using revision surgery as the dependent variable and HO as the independent variable. We compared Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores between participants with and those without HO at 24 months. Of 1,441 participants in the study, 287 (19.9%) developed HO within 24 months. HO was not associated with subsequent revision surgery. Grade-III HO was associated with statistically significant and clinically relevant deterioration in the total WOMAC score, which was mainly related to the function component of the score, compared with grade I or II. The impact of grade-III HO on the functional outcomes and quality of life after THA for hip fracture is clinically important, and HO prophylaxis for selected high-risk patients may be appropriate. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Sections du résumé
BACKGROUND
Heterotopic ossification (HO) is a frequent complication following hip surgery. Using data from the Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemiarthroplasty (HEALTH) trial, we aimed to (1) determine the prevalence of HO following total hip arthroplasty (THA) for femoral neck fracture in patients ≥50 years of age, (2) identify whether HO is associated with an increased risk of revision surgery within 24 months after the fracture, and (3) determine the impact of HO on functional outcomes.
METHODS
We performed a multivariable Cox regression analysis using revision surgery as the dependent variable and HO as the independent variable. We compared Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores between participants with and those without HO at 24 months.
RESULTS
Of 1,441 participants in the study, 287 (19.9%) developed HO within 24 months. HO was not associated with subsequent revision surgery. Grade-III HO was associated with statistically significant and clinically relevant deterioration in the total WOMAC score, which was mainly related to the function component of the score, compared with grade I or II.
CONCLUSIONS
The impact of grade-III HO on the functional outcomes and quality of life after THA for hip fracture is clinically important, and HO prophylaxis for selected high-risk patients may be appropriate.
LEVEL OF EVIDENCE
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Identifiants
pubmed: 33764913
doi: 10.2106/JBJS.20.01586
pii: 00004623-202107210-00010
pmc: PMC8388546
mid: NIHMS1719527
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1328-1334Subventions
Organisme : NIAMS NIH HHS
ID : R01 AR055130
Pays : United States
Organisme : NIAMS NIH HHS
ID : UM1 AR063386
Pays : United States
Informations de copyright
Copyright © 2021 by The Journal of Bone and Joint Surgery, Incorporated.
Déclaration de conflit d'intérêts
Disclosure: The Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemiarthroplasty (HEALTH) trial was supported by research grants from the Canadian Institutes of Health Research (CIHR) (MCT-90168), National Institutes of Health (NIH) (1UM1AR063386-01), ZorgOnderzoek Nederland-medische wetensehappen (ZonMw) (17088.2503), Sophies Minde Foundation for Orthopaedic Research, McMaster Surgical Associates, and Stryker Orthopaedics. The funding sources had no role in design or conduct of the study; the collection, management, analysis, or interpretation of the data; or the preparation, review, or approval of the manuscript. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links.lww.com/JBJS/G429).
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