This 2007 narrative review from Wrightington Hospital synthesizes evidence on heterotopic ossification (HO) after lower limb arthroplasty — covering its incidence, the Brooker classification, risk factors, pathophysiology, and the comparative evidence for radiotherapy versus NSAID prophylaxis.
Routine HO prophylaxis is not evidence-based for all arthroplasty patients, but high-risk cases (prior HO, ankylosing spondylitis, hypertrophic OA, DISH) warrant single-dose radiotherapy (7–8 Gy) over extended indometacin given its superior efficacy and avoidance of nonunion and bleeding risks.
When excising symptomatic HO, always add prophylaxis — combination radiotherapy plus indometacin is the strongest current option despite being retrospective evidence only.
This 2007 narrative review from Wrightington Hospital synthesizes evidence on heterotopic ossification (HO) after lower limb arthroplasty — covering its incidence, the Brooker classification, risk factors, pathophysiology, and the comparative evidence for radiotherapy versus NSAID prophylaxis.
Routine HO prophylaxis is not evidence-based for all arthroplasty patients, but high-risk cases (prior HO, ankylosing spondylitis, hypertrophic OA, DISH) warrant single-dose radiotherapy (7–8 Gy) over extended indometacin given its superior efficacy and avoidance of nonunion and bleeding risks.
When excising symptomatic HO, always add prophylaxis — combination radiotherapy plus indometacin is the strongest current option despite being retrospective evidence only.