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Chemoprophylaxis for Heterotrophic Ossification Following Hip Arthroscopy: A Systematic Review

Robert S. Dean, Britanny A. Hamama, Leonardo M. Cavinatto, S. Nho, J. Chahla, B. Hinckel

Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine, 2023

6,463 participants · 10 citations

Abstract

INTRODUCTION

Heterotrophic ossification (HO) is a known complication diagnosed following hip arthroscopy.

PURPOSE/HYPOTHESIS

This study sought to review the current literature on chemoprophylaxis for HO following hip arthroscopy and to describe what agents and doses are being utilized.

STUDY DESIGN

Systematic Review.

METHODS

A systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines on the use of chemoprophylactic medications for HO prevention following hip arthroscopy. Mechanical and radiation prophylaxis were not included in the current analysis.

RESULTS

A total of 203 studies were identified, of which 15 were included with 6463 patients. There was one randomized control trial (RCT) and 4 additional comparative studies. The most commonly utilized chemoprophylactic agents were the following: naproxen (n=8), celecoxib (n=3), indomethacin (n=3), aspirin (n=1), etoricoxib (n=1), and etodolac (n=1), and non-specific Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) (n=1). Naproxen was either given at a dose of 500 mg once or twice daily for 2 to 4 weeks. RCTs and additional comparative studies showed significant HO prevention using chemoprophylactic agents following hip arthroscopy.

CONCLUSIONS

Heterotopic ossification is a known and common complication following hip arthroscopy. The current systematic review found significant heterogeneity across the literature with respect to specific chemoprophylactic…

How strong is the evidence?

Evidence Hub reads this as a systematic review. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 6,463 participants or records.

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