Clinical Analysis Of Heterotopic Ossification After Hip Replacement

ObjectiveTo Study the incidence rate, risk factors, and possible sites of postoperative heterotopic ossification (HO) for hip replacement using Posterolateral approach, and discuss the possibility of the treatment of heterotopic ossification (HO) after hip replacement by using Activating blood and dissolving stasis methods in the Perioperative.methodsWe analysized 101 patients (108 hips) after hip replacement to investegate the HO incidence with clinical imformation and X-ray. All of the patients were followed up 17.26±23.60 months (4-90 months) on average. Diagnosis is based on the hip antero-posterior X-ray. all the HO case was divided into four grades according to Brooker classification records and occurrence of HO site. The results were analyzed by statistics SPSS 17.0 software package, Comparison of the two groups using chi-square test; Correlation analysis using Uncond-itional logistic stepwise regression analysis. We analyzised Gender, age, primary disease, the Situation of using Activating blood and dissolving stasis methods and a possible site and finding risk factors.Results8 hips had HO Among the 108 Hips, total incidence rate was 7.41%, while 8.92% in total hip replacement,5.69% in femoral head replacement. There was no significant difference between femoral head replacement and total hip replacement about incidence rate of heterotopic ossification (X2=0.07, P> 0.05). there were five hips of gradeⅠ(4.62%),1 hip of gradeⅡ(0.92%), two hip of gradeⅢ(1.85%),O hip of gradeⅣ(0%) according to Brooker classification. There was difference between men and women about incidence rate of heterotopic ossification, the difference was statistically significant (X2=4.88, P<0.05.), its occurrence rate was 16.67% in men and 2.78% in women. The incidence rate were increased Aomong the rheumatoid arthritis, osteonecrosis, femoral neck fracture, hip arthroplasty, the heterotopic ossification after hip replacement. patients with hip surgery history were more possible to have HO. There was no risk factors in patient with no past surgical hostroy after bilateral hip replacement. Elderly patients over 65 years old are more possible to have HO than the patients under 65 years old, but there was no difference significantly between the two groups (X2=0.69, P> 0.05). lesser trochanter were more possible to have HO than adductor muscle site through the Posterolateral approach, the ratio was 3:1Conclusion1. this study show significantly relationship between heterotopic ossification prediction sites and surgical approaches after hip replacement in the HO occurred mostly in the Department of adductor muscle lesser trochanter site through posterolateral approach.2. Male, hip revision surgery are high risk factors, That need to strengthen preventive measures for these patients. The factors including age, no hip surgery history, bilateral hip replacement dod not appear to significantly increase the risk of HO.3. Prophylaxis methods perioperatively may reduce the incidence of heterotopic ossification in the hip replacement. but there is not significant difference between the femoral head replacement and total hip replacement by using Activating blood and dissolving stasis methods.