ArticleArchives of orthopaedic and trauma surgery2021
Heterotopic ossification in primary total hip arthroplasty using the posterolateral compared to the direct lateral approach.
Article in Archives of orthopaedic and trauma surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Gait and function after total hip arthroplasty: a systematic review and meta-analysis of the Hardinge versus posterolateral approaches.BMC musculoskeletal disorders · 2026Pooled it
- Selective versus non-selective NSAIDs as prophylaxis for heterotopic ossification following hip arthroplasty: a meta-analysis.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2022Pooled it
- Direct lateral vs. posterior-lateral approach in robotic-assisted total hip arthroplasty: clinical and radiographic comparison.Archives of orthopaedic and trauma surgery · 2025Article
- Prevention of heterotopic ossification in primary total hip arthroplasty: a bone in the dark.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Efficacy of ibuprofen and indomethacin as prophylaxis of heterotopic ossification: a comparative study.Scientific reports · 2023Article
- Efficacy of Ibuprofen after Total Hip Arthroplasty to Prevent Heterotopic Ossification: Systematic Review and Meta-Analysis.Revista brasileira de ortopedia · 2023Article
- Total Hip Arthroplasty Performed with a Novel Design Type 1 Femoral Stem: A Retrospective Minimum 5-Year Follow-up Study.Clinics in orthopedic surgery · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTotal hip arthroplasty (THA) is a successful procedure. However, in time, heterotopic ossification (HO) can form due to, amongst others, soft tissue damage. This can lead to pain and impairment. This study compares the formations of HO between patients who underwent either THA with the posterolateral approach (PA) or with the direct lateral approach (DLA). Our hypothesis is that patients who underwent THA with a PA form less HO compared to THA patients who underwent DLA.
methodsIn this prospective cohort study, 296 consecutive patients were included who underwent THA. A total of 127 patients underwent THA with the PA and 169 with the DLA. This was dependent on the surgeon's preference and experience. More than 95% of patients had primary osteoarthritis as the primary diagnosis. Clinical outcomes were scored using the Numeric Rating Scale (NRS) and Harris Hip Score (HHS), radiological HO were scored using the Brooker classification. Follow-up was performed at 1 and 6 years postoperatively.
resultsTwo hundred and fifty-eight patients (87%) completed the 6-year follow-up. HO formation occurred more in patients who underwent DLA, compared to PA (43(30%) vs. 21(18%), p = 0.024) after 6 years. However, the presence of severe HO (Brooker 3-4) was equal between the DLA and PA (7 vs. 5, p = 0.551). After 6 years the HHS and NRS for patient satisfaction were statistically significant higher after the PA (95.2 and 8.9, respectively) compared to the DLA (91.6 and 8.5, respectively) (p < 0.001 and p = 0.003, respectively). The NRS for load pain was statistically significant lower in the PA group (0.5) compared to the DLA group (1.2) (p = 0.004). The NRS for rest pain was equal: 0.3 in the PA group and 0.5 in the DLA group.
conclusionTHA with the PA causes less HO formation than the DLA.
trial registrationRegistrated as HipVit trial, NL 32832.100.10, R-10.17D/HIPVIT 1. Central Commission Human-Related research (CCMO) Registry.
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