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The Journal of Bone and Joint Surgery, Vol 77, Issue 4 590-595, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Single-dose irradiation for the prevention of heterotopic ossification after total hip arthroplasty. A comparison of doses of five hundred and fifty and seven hundred centigray
WL Healy, TC Lo, AA DeSimone, B Rask and BA Pfeifer
Department of Orthopaedic Surgery, Lahey Clinic, Burlington, Massachusetts 01805, USA.
One hundred and seven hips (ninety-four patients) that had risk factors
associated with the development of heterotopic ossification after total hip
arthroplasty were treated with a single dose of radiation after the
operation in an attempt to prevent the formation of heterotopic bone. A
study was conducted to compare the efficacy of a single dose of 550
centigray (nineteen hips) with that of a single dose of 700 centigray
(eighty-eight hips). Heterotopic ossification developed in twelve (63 per
cent) of the nineteen hips that were treated with 550 centigray; grades 1,
2, and 3, according to the classification of Brooker et al., developed in
four hips each. Two of the patients who received 550 centigray were
symptomatic. Heterotopic ossification developed in nine (10 per cent) of
the eighty-eight hips that were treated with 700 centigray; the lesion was
grade 1 in six, grade 2 in one, and grade 3 in two. None of the patients
who received 700 centigray were symptomatic. We concluded that single-dose
irradiation consisting of 550 centigray is inadequate for the prevention of
heterotopic ossification in high-risk patients after total hip
arthroplasty. We recommend a dose of 700 centigray as effective prophylaxis
for these patients.
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