Researchers report that a recent study confirms the efficacy, and tolerability of pharmacological prophylaxis of heterotopic ossification following total hip anthroplasty. The prospective, observational, multi-center study reportedly encompassed 480 consecutive patients who underwent primary total hip anthroplasty during the year 2009. Researchers say patients were followed radiographically for 12 months following surgery in order to assess the incidence of periprosthetic heterotopic ossification.
According to the study, surgeons chose whether to administer pharmacological prophylaxis, and were also asked to record the duration of the prophylaxis, if chosen. Surgeons who chose not to use pharmacological prophylaxis were asked to provide reasons for their decision. Researchers add that participating centers agreed to use only the drug celecoxib, which had already been proven effective.
The study’s results indicate that 368 patients were treated with celecoxib and 112 patients were not treated with any prophylaxis. The study also highlights the reported reasons behind surgeons opting not to administer celecoxib, which included opinions that the routine use of prophylaxis was not necessary for 75% of study participants, previous history of gastrointestinal bleeding exhibited in 18% of participants, and concomitant cardiorenal pathologies in 7% of participants.
The results suggest overall, the incidence of heterotopic ossification in the celecoxib-treated patients was 23% (with no cases of Booker grade 3 or 4 ossifications), compared to a 55% incidence in untreated study participants (with Booker grade 3 and 4 reported in 9%). Researchers say a multivariate analysis spotlighted celecoxib prophylaxis as the single most vital variable in predicting the occurrence of heterotopic ossification.
Researchers conclude that the study confirms the efficacy and tolerability of celecoxib for the prophylaxis of heterotopic ossification after total hip anthroplasty. In addition, researchers emphasize that the results display the key role a surgeon’s belief that routine prevention is not necessary plays in the determination of the complication.