Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
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Case Reports Randomized Controlled Trial Comparative Study Clinical Trial
[Prevention of periarticular ossification following endoprosthetic hip replacement using postoperative irradiation].
The development of heterotopic ossification (HO) after total hip replacement or other surgical hip procedures can considerably impair the functional result and quality of life in up to 73% of all patients. Predisposing high risk factors for heterotopic ossification are severe pre-intra- and/or postoperative hip trauma, previous development of ipsi- and/or contralateral heterotopic ossification, hypertrophic osteoarthritis, active rheumatoid spondylarthritis as well as male sex. Over the past two decades a variety of surgical, pharmaceutical and radiotherapeutic prophylactic measurements have been proposed and tested in clinical trials. ⋯ Radiotherapy treatment duration and additional medication had no impact on the outcome. In conclusion postoperative radiotherapy has shown high efficacy in prevention of heterotopic ossification as long as the treatment is initiated within the first four days after surgery. With respect to acute toxicity postoperative radiotherapy seems to be without any competition compared to surgical and pharmaceutical approaches including corticoid, diphosphonate and nonsteroid antiphlogistic drugs.