Abstract
Study design: Clinical study.
Objectives: To evaluate indications of hip endoprosthesis in periarticular ossifications.
Setting: A Spinal Cord Injury Centre in Germany.
Methods: Clinical examination, X-ray control.
Results: Surgery of periarticular ossification (paraosteoarthropathy, POA) either involves simple resection of the ossification or removal of the hip. The latter has an impact on the sitting posture with concomitant increased pressure sore risk. Nevertheless the hip is biomechanically important in paraplegics. We are investigating the outcome of total hip replacement (THR) in patients with ankylosis due to periarticular ossification. Six hip replacement cases seen in follow-up of up to 24 months showed no loosening, with good mobility of the joint. We follow a strict perioperative POA prophylaxis, which resulted in each case reporting only a slight recurrence (Brooker 1–2) without any loss of functional mobility.
Conclusion: In ankylotic hips with mobility/social/hygenic problems we favour a hip replacement in cases with osteoarthritis or high risk of osteoporotic fracture. A replacement of the joint should be preferred to a Girdlestone operation.
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References
Röhl K, Weidt F & Becker S . Behandlungsstratagien heterotoper Ossifikationen der oberen Extremitäten bei Rückenmarkverletzten. Trauma Berufskrankh 2000; 2: 358–363.
Subbarao JV & Garrison SJ . Heterotopic Ossification: Diagnosis and management, current concept and controversies. J Spinal Cord Med 1999; 22: 273–281.
Speed J . Heterotopic Ossification. eMedicine Journal 2001; Volume 2, Number 6.
Brooker AF et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 1973; 55: 1629–1632.
Gerner HJ . Die Querschnittlähmung, Berlin: Blackwell Wissenschaft, 1992; p 113ff
Rossier AB et al. Current facts of para-osteo-arthropathy (POA). Paraplegia 1973; 11: 38–78.
Becker S et al. Biomechanical aspects in femoral osteotomies for hip dysplasia in adults. J Bone Joint Surg Br 1998; 80 (Suppl): B1–B9.
Meiners T, Abel R, Bohm V & Gerner HJ . Resection of heterotopic ossification of the hip in spinal cord injured patients. Spinal Cord 1997; 35: 443–445.
Root L, Goss JR & Mendes J . The treatment of the painful hip in cerebral palsy by total hip replacement of hip arthrodesis. J Bone Joint Surg Am 1986; 68: 590–598.
Buly RL et al. Total hip arthroplasty in cerebral palsy. Long-term follow-up results. Clin Orthop 1993; 296: 148–153.
Hofmann, et al. General short-term indomethacin prophylaxis to prevent heterotopic ossification in total hip arthroplasty. Orthopedics 1999; 22: 207–211.
Banovac K, Williams J, Patrick L & Haniff Y . Prevention of heterotopic ossification after spinal cord injury with indomethacin. Spinal Cord 2001; 39: 370–374.
Sautter-Bihl ML, Hultenschmidt B, Liebermeister E & Nanassy A . Fractionated and single-dose radiotherapy for heterotopic bone formation in patients with spinal cord injury. A phase-I/II study. Strahlenther Onkol 2001; 177: 200–205.
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Becker, S., Röhl, K. & Weidt, F. Endoprosthesis in paraplegics with periarticular ossification of the hip. Spinal Cord 41, 29–33 (2003). https://doi.org/10.1038/sj.sc.3101387
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DOI: https://doi.org/10.1038/sj.sc.3101387
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