Chinese Journal of Tissue Engineering Research ›› 2017, Vol. 21 ›› Issue (11): 1641-1646.doi: 10.3969/j.issn.2095-4344.2017.11.001

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Risk factors for heterotopic ossification following total hip arthroplasty in patients with ankylosing spondylitis   

Liu Yong1, Huo Shao-chuan2, Zhou Chi3, Tang Hong-yu3, Chen De-long1, Chen Jian-fa3, Guo Hai1, Deng Zhang-rong1, Wang Hai-bin3   

  1. 1the First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; 2the Third Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; 3Orthopedics Center, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • Revised:2017-02-24 Online:2017-04-18 Published:2017-05-06
  • Contact: Wang Hai-bin, Chief physician, Doctoral supervisor, Orthopedics Center, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • About author:Liu Yong, Studying for master’s degree, the First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • Supported by:

    the National Natural Science Foundation of China, No. KBC110134K11; the Natural Science Foundation of Guangdong Province, No. 2015A030310203

Abstract:

BACKGROUND: Heterotopic ossification (HO) is common following primary total hip arthroplasty (THA) in patients with ankylosing spondylitis (AS), which may cause certain influence on functional recovery.

OBJECTIVE: To explore the risk factors for HO after primary THA in AS patients.
METHODS: The clinical and radiological data from 87 patients (132 hips) with AS undergoing primary THA between June 2011 and December 2015 were retrospectively analyzed, and followed up for more than 6 months. The radiological information included preoperative and postoperative hip anteroposterior and lateral radiographs. The presence of HO surrounding the prosthesis was evaluated on the radiographs at the last follow-up and graded according to the Brooker classification. Risk factors for HO were divided into invariable factors (age, sex, course and with or without ankylosed hip) and variable factors (preoperative C-reactive protein level, preoperative erythrocyte sedimentation rate, intraoperative blood loss, operation time, prosthesis types and anesthesia methods) to determine the pertinent risk factors.

RESULTS AND CONCLUSION: (1) Totally 43 hips (32.6%) were found to have developed into HO. (2) Invariable risk factors including male (P=0.029), preoperative ankylosed hip (P < 0.001), and course (P=0.029) increased the prevalence of HO. Among the variable risk factors, prolonged operation time (P=0.031) and general anesthesia (P=0.003) were associated with the increased occurrence of HO. Age, preoperative C-reactive protein level and erythrocyte sedimentation rate, intraoperative blood loss, and prosthesis types had no obvious correlation with HO. (3) These results suggest that to prevent the formation of HO following THA in AS, efforts to reduce the operation time and avoid general anesthesia should be considered.

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

Key words: Arthroplasty, Replacement, Hip, Ossification, Heterotopic, Prosthesis Implantation, Tissue Engineering

CLC Number: