Efficacy of NSAIDs versus Radiotherapy for Heterotopic Ossification Prophylaxis Following Total Hip Arthroplasty in High-Risk Patients: A Systematic Review and Meta-Analysis

Efficacy of NSAIDs versus Radiotherapy for Heterotopic Ossification Prophylaxis Following Total Hip Arthroplasty in High-Risk Patients: A Systematic Review and Meta-Analysis

Authors

Shapira J, Yelton MJ, Chen JW, Rosinsky PJ, Maldonado DR, Meghpara M, Lall AC, Domb BG
DOI: 10.1177/1120700021991115

Background

Heterotopic ossification (HO) is the abnormal formation of bone in soft tissues and is a potential complication following total hip arthroplasty (THA). This study compares the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) and radiotherapy (RT) in preventing HO formation in high-risk patients after THA.

Methods

A systematic review and meta-analysis were performed, analyzing 37 studies (including randomized controlled trials) on HO prophylaxis following THA. The incidence of HO in patients using NSAIDs or RT was compared, specifically looking at non-selective NSAIDs and COX-II selective NSAIDs.

Key Findings

NSAIDs were more effective than RT in preventing HO formation in high-risk patients after THA. Both non-selective and COX-II selective NSAIDs had similar efficacy. Patients treated with NSAIDs showed lower rates of HO formation compared to those receiving RT.

Conclusions

NSAIDs, especially non-selective types, may offer better efficacy than RT in preventing HO formation in high-risk THA patients. The choice of prophylaxis should also consider other factors like comorbidities and side effects.

What Does This Mean for Patients

If you're at high risk for HO following hip replacement surgery, NSAIDs might be a more effective preventive measure than radiotherapy. Discuss your options with your doctor to find the best approach for you.