Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort
Background: Heterotopic ossification (HO) is a well-known complication of arthroscopic and open surgical treatment of femoroacetabular impingement (FAI). Incidence of heterotopic ossification has been reported in the literature between 0% and 44% after hip arthroscopy and between 18.2% and 25% after...
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| Format: | Article |
| Language: | English |
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EDP Sciences
2023-01-01
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| Series: | SICOT-J |
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| Online Access: | https://www.sicot-j.org/articles/sicotj/full_html/2023/01/sicotj230039/sicotj230039.html |
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| author | Olivero Matteo Capurro Bruno Reis-Campos Pedro Aprato Alessandro Ayeni Olufemi Chawla Anuj Larrainzar Garijo Ricardo Marín-Peña Oliver |
| author_facet | Olivero Matteo Capurro Bruno Reis-Campos Pedro Aprato Alessandro Ayeni Olufemi Chawla Anuj Larrainzar Garijo Ricardo Marín-Peña Oliver |
| author_sort | Olivero Matteo |
| collection | DOAJ |
| description | Background: Heterotopic ossification (HO) is a well-known complication of arthroscopic and open surgical treatment of femoroacetabular impingement (FAI). Incidence of heterotopic ossification has been reported in the literature between 0% and 44% after hip arthroscopy and between 18.2% and 25% after anterior mini-open surgery. Currently, pharmacological prophylaxis with NSAIDs and selective COX-2 inhibitors are commonly used and their effectiveness is well documented in literature. Hypothesis: We hypothesized that the low-dose prophylaxis protocol with selective cox-2 inhibitors decreases the risk of heterotopic ossification in open or arthroscopic hip preservation surgery in athletes. Methods: This study is an analysis of prospectively gathered data on 98 sport participant patients who underwent arthroscopic or anterior mini-open treatment for FAI between April 2008 and April 2018. All the patients received postoperative oral prophylaxis with 60 mg etoricoxib once daily for two weeks. Post-operative X-rays were performed at 1, 3, and 12 months after surgery and reviewed by two orthopedic surgeons blinded to the type and side of surgery. HO were graded according to the Brooker classification. Descriptive statistics was used to analyze demographic data. Bivariate analysis was performed to analyze the association of HO with each of the following variables: type of surgery, physical activity, time of evolution of symptoms, age at surgery, and sex. Finally, a regression model analysis was performed to determine the presence of confounding effects between variables. Results: The study cohort was composed of 54 patients in the arthroscopic treatment group and 44 patients in the anterior mini-open group. HO was identified in 6 (13.6%) patients in the mini-open group. No HO was identified in the arthroscopic group. In the bivariate analysis, “type of surgery” was the only variable that showed a statistically significant association with HO (p = 0.007). Conclusion: Results of this study suggest that anterior mini-open treatment was characterized by a higher risk of HO development compared to hip arthroscopy for femoroacetabular impingement treatment regardless of pharmacological prophylaxis. The treatment regimen of 60 mg etoricoxib daily for two weeks was an effective prophylaxis for HO formation in sport participant patients compared with data available in the literature. |
| first_indexed | 2024-03-11T21:44:52Z |
| format | Article |
| id | doaj.art-b30949e793fd4dd1a96a029009e1e5ac |
| institution | Directory Open Access Journal |
| issn | 2426-8887 |
| language | English |
| last_indexed | 2024-03-11T21:44:52Z |
| publishDate | 2023-01-01 |
| publisher | EDP Sciences |
| record_format | Article |
| series | SICOT-J |
| spelling | doaj.art-b30949e793fd4dd1a96a029009e1e5ac2023-09-26T10:13:32ZengEDP SciencesSICOT-J2426-88872023-01-0192710.1051/sicotj/2023024sicotj230039Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohortOlivero Matteo0Capurro Bruno1https://orcid.org/0000-0002-0360-1958Reis-Campos Pedro2Aprato Alessandro3https://orcid.org/0000-0002-2514-4719Ayeni Olufemi4Chawla Anuj5https://orcid.org/0000-0001-8890-655XLarrainzar Garijo Ricardo6https://orcid.org/0000-0002-0501-2006Marín-Peña Oliver7https://orcid.org/0000-0002-7814-5766Centro Traumatológico Ortopédico, (CTO), University of TorinoDepartment of Orthopaedic Surgery and Sport Traumatology, IMSKE HospitalOrthopedic and Traumatology Department, Hospital Vila Franca de XiraCentro Traumatológico Ortopédico, (CTO), University of TorinoDivision of Orthopaedic Surgery, Department of Surgery, McMaster University Medical CenterDepartment of Orthopaedic Surgery, Tan Tock Seng HospitalDepartment of Orthopaedic Surgery and Traumatology, Hospital Universitario Infanta LeonorDepartment of Orthopaedic Surgery and Traumatology, Hospital Universitario Infanta LeonorBackground: Heterotopic ossification (HO) is a well-known complication of arthroscopic and open surgical treatment of femoroacetabular impingement (FAI). Incidence of heterotopic ossification has been reported in the literature between 0% and 44% after hip arthroscopy and between 18.2% and 25% after anterior mini-open surgery. Currently, pharmacological prophylaxis with NSAIDs and selective COX-2 inhibitors are commonly used and their effectiveness is well documented in literature. Hypothesis: We hypothesized that the low-dose prophylaxis protocol with selective cox-2 inhibitors decreases the risk of heterotopic ossification in open or arthroscopic hip preservation surgery in athletes. Methods: This study is an analysis of prospectively gathered data on 98 sport participant patients who underwent arthroscopic or anterior mini-open treatment for FAI between April 2008 and April 2018. All the patients received postoperative oral prophylaxis with 60 mg etoricoxib once daily for two weeks. Post-operative X-rays were performed at 1, 3, and 12 months after surgery and reviewed by two orthopedic surgeons blinded to the type and side of surgery. HO were graded according to the Brooker classification. Descriptive statistics was used to analyze demographic data. Bivariate analysis was performed to analyze the association of HO with each of the following variables: type of surgery, physical activity, time of evolution of symptoms, age at surgery, and sex. Finally, a regression model analysis was performed to determine the presence of confounding effects between variables. Results: The study cohort was composed of 54 patients in the arthroscopic treatment group and 44 patients in the anterior mini-open group. HO was identified in 6 (13.6%) patients in the mini-open group. No HO was identified in the arthroscopic group. In the bivariate analysis, “type of surgery” was the only variable that showed a statistically significant association with HO (p = 0.007). Conclusion: Results of this study suggest that anterior mini-open treatment was characterized by a higher risk of HO development compared to hip arthroscopy for femoroacetabular impingement treatment regardless of pharmacological prophylaxis. The treatment regimen of 60 mg etoricoxib daily for two weeks was an effective prophylaxis for HO formation in sport participant patients compared with data available in the literature.https://www.sicot-j.org/articles/sicotj/full_html/2023/01/sicotj230039/sicotj230039.htmlheterotopic ossificationfemoroacetabular impingementpost-operative prophylaxiship arthroscopy |
| spellingShingle | Olivero Matteo Capurro Bruno Reis-Campos Pedro Aprato Alessandro Ayeni Olufemi Chawla Anuj Larrainzar Garijo Ricardo Marín-Peña Oliver Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort SICOT-J heterotopic ossification femoroacetabular impingement post-operative prophylaxis hip arthroscopy |
| title | Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort |
| title_full | Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort |
| title_fullStr | Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort |
| title_full_unstemmed | Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort |
| title_short | Low-dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort |
| title_sort | low dose prophylaxis protocol for heterotopic ossification after hip preservation surgery in a sport participants cohort |
| topic | heterotopic ossification femoroacetabular impingement post-operative prophylaxis hip arthroscopy |
| url | https://www.sicot-j.org/articles/sicotj/full_html/2023/01/sicotj230039/sicotj230039.html |
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