Severity of heterotopic ossification in patients following surgery for hip fracture: a retrospective observational study.

Autor: Hayashi D; Department of Radiology, Stony Brook Medicine, HSC 4-120, Stony Brook, NY, 11794, USA. Daichi.Hayashi@stonybrookmedicine.edu., Gould ES; Department of Radiology, Stony Brook Medicine, HSC 4-120, Stony Brook, NY, 11794, USA., Ho C; Department of Radiology, Stony Brook Medicine, HSC 4-120, Stony Brook, NY, 11794, USA.; Department of Radiology, University of Colorado School of Medicine, Aurora, CO, USA., Caruana DL; Yale School of Medicine, New Haven, CT, USA., Komatsu DE; Department of Orthopedics, Stony Brook Medicine, Stony Brook, NY, USA., Yang J; Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA., Zhu C; Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, USA., Mufti M; Department of Radiology, Stony Brook Medicine, HSC 4-120, Stony Brook, NY, 11794, USA., Nicholson J; Department of Orthopedics, Stony Brook Medicine, Stony Brook, NY, USA.
Jazyk: angličtina
Zdroj: BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2019 Jul 27; Vol. 20 (1), pp. 348. Date of Electronic Publication: 2019 Jul 27.
DOI: 10.1186/s12891-019-2725-7
Abstrakt: Background: Heterotopic ossification (HO) is a relatively common complication following hip surgery treated with open reduction and internal fixation, total arthroplasty or hemiarthroplasty. Development of HO after hip surgery is an important clinical issue as it can affect functional status. We aimed to determine whether there was association between severity of heterotopic ossification about the hip and the interval between the time of hip fracture and surgery.
Materials and Methods: Our retrospective study included 151 patients (age range 33-95 years) treated for hip fractures by hemiarthroplasty. Medical records were reviewed for time interval to surgery, laterality, surgical approach, and patient age. Patients who had any post-operative complications were excluded. Radiographs were semiquantitatively assessed for the degree of heterotopic ossification based on Brooker Classification (5-point scale). Statistical analysis was performed utilizing Chi-square, Kruskal-Wallis, and Score tests, and also a proportional odds model (significance level set at 0.05).
Results: Thirty eight patients had no heterotopic ossification, 43 had class 1, 55 had class 2, and 15 had class 3 or greater heterotopic ossification. The majority of patients (59.6%) had surgery within 2 days of acute injury. Severe heterotopic ossification (HO 3+) was associated with the longer interval between the time of acute hip fracture and surgery (median 6 days) vs. median 2 days in all other groups (HO classes 0-2) (p = 0.0015). The odds ratio and 95% CI for one level higher HO class was 1.296 (1.152, 1.459), which meant that the odds of having HO class one level higher increased by about 29.6% for every one-day increase in the days to surgery. No significant association was found for other variables.
Conclusion: Class 3 or greater HO was associated with longer time interval between time of acute hip fracture and surgery compared to all other groups (HO class 0-2).
Databáze: MEDLINE
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