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Incidence of heterotopic ossification following hip arthroscopy is low: considerations for routine prophylaxis.

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cam.issuedOnline2022-04-28
dc.contributor.authorArshad, Zaki
dc.contributor.authorMaughan, Henry David
dc.contributor.authorGarner, Malgorzata
dc.contributor.authorAli, Erden
dc.contributor.authorKhanduja, Vikas
dc.contributor.orcidArshad, Zaki [0000-0002-2143-7792]
dc.contributor.orcidKhanduja, Vikas [0000-0001-9454-3978]
dc.date.accessioned2022-06-07T08:13:11Z
dc.date.available2022-06-07T08:13:11Z
dc.date.issued2022-07
dc.date.submitted2022-02-01
dc.date.updated2022-06-07T08:13:11Z
dc.description.abstractPURPOSE: This scoping review aims to map and summarise the available literature on heterotopic ossification (HO) following hip arthroscopy, with particular focus on incidence, distribution as per Brooker classification, efficacy of prophylactic measures and factors that may influence the likelihood of production of HO. METHODS: A computer-based search was performed on PubMed, Embase, Emcare, Cinahl, ISI web of science and Scopus using the terms 'heterotopic ossification' and 'hip arthroscopy'. Articles reporting heterotopic ossification following hip arthroscopy for any condition were included after two-stage title/abstract and full-text screening. RESULTS: Of the 663 articles retrieved, 45 studies were included. The proportion of patients with HO ranged from 0 to 44%. The majority of the cases were either Brooker grade I or II. Of the six studies investigating the effect of NSAID prophylaxis, five reported a significantly lower incidence of heterotopic ossification associated with its use. Weak evidence suggests that an outside-in arthroscopic approach, no capsular closure, male sex and mixed cam and pincer resection may be associated with an increased risk of HO. CONCLUSION: Although there is a large variation in rates of HO following hip arthroscopy in the current literature, the majority of studies report a low incidence. Evidence exists advocating the administration of post-operative NSAIDs to reduce the incidence of HO following hip arthroscopy. This, combined with the low risk of complications, means there is a favourable risk-benefit ratio for prophylactic NSAID used in HA. Future research should work to identify patient clinical and demographic factors which may increase the risk of development of HO, allowing clinicians to risk stratify and select only specific patients who would benefit from receiving NSAID prophylaxis.
dc.identifier.doi10.17863/CAM.85200
dc.identifier.eissn1432-5195
dc.identifier.issn0341-2695
dc.identifier.others00264-022-05402-4
dc.identifier.other5402
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/337791
dc.languageen
dc.language.isoeng
dc.publisherSpringer Science and Business Media LLC
dc.publisher.urlhttp://dx.doi.org/10.1007/s00264-022-05402-4
dc.subjectHeterotopic ossification
dc.subjectHip arthroscopy
dc.subjectProphylaxis
dc.subjectScoping review
dc.subjectAnti-Inflammatory Agents, Non-Steroidal
dc.subjectArthroplasty, Replacement, Hip
dc.subjectArthroscopy
dc.subjectHumans
dc.subjectIncidence
dc.subjectMale
dc.subjectOdds Ratio
dc.subjectOssification, Heterotopic
dc.subjectPostoperative Complications
dc.titleIncidence of heterotopic ossification following hip arthroscopy is low: considerations for routine prophylaxis.
dc.typeArticle
dcterms.dateAccepted2022-04-04
prism.endingPage1500
prism.issueIdentifier7
prism.publicationNameInt Orthop
prism.startingPage1489
prism.volume46
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1007/s00264-022-05402-4

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