Evidence map›Paper›PMID 41213296›Full record

ArticleBone & joint open2025

A new classification for heterotopic ossification following periacetabular osteotomy with and without concomitant hip arthroscopy.

Ta-Wei Tai, Diego J Restrepo, Sergio F Guarin Perez, Adrian E Gonzalez-Bravo, Onur Hapa, Rafael J Sierra

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Article in Bone & joint open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 citing paper in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Ta-Wei TaiDepartment of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Diego J RestrepoDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, USA.
Sergio F Guarin PerezDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, USA.
Adrian E Gonzalez-BravoDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, USA.
Onur HapaDepartment of Orthopedic Surgery, Dokuz Eylül University, İzmir, Turkey.
Rafael J SierraDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: Heterotopic ossification (HO) is a recognized complication following periacetabular osteotomy (PAO), but its patterns, incidence, and clinical relevance remain poorly defined. The commonly used Brooker classification, developed for total hip arthroplasty, is not fully applicable to HO after PAO. This study aimed to propose a new classification system specific to HO after PAO, evaluate its clinical relevance, and report the cumulative probabilities of radiological and symptomatic HO. Methods: This retrospective study included 643 patients who underwent PAO between January 2006 and July 2024. A total of 308 patients (47.9%) had concomitant arthroscopic procedures. Radiographs were analyzed to identify HO using both the Brooker classification and a newly developed system. The cumulative probabilities of radiological and symptomatic HO were calculated using Kaplan-Meier analysis. Difference of variables between patients with and without HO was analyzed. Receiver operating characteristic (ROC) curve analysis was used to compare the predictive performance of the two classification systems. Results: The cumulative probabilities of radiological and symptomatic HO at five years post-PAO were 30.4% and 3.8%, respectively. The probabilities were 41.9% in males and 29.2% in females. Four patients (2.8%) required surgical excision of HO, all classified as type 3 or 4 under the new system. The ROC analysis demonstrated superior predictive performance for the new classification system (AUC = 0.928) compared to the Brooker classification (AUC = 0.697; p = 0.007). No significant differences were found between the patients with and without HO in terms of age, sex, concomitant arthroscopic procedures, or receiving prophylaxis in addition to low-dose aspirin. Conclusion: This study highlighted the cumulative probabilities of HO following PAO and introduced a new classification system that improved clinical relevance and predictive accuracy. These findings have provided insights into the incidence and management of HO after PAO, and laid the groundwork for standardized reporting and future research.

Identifiers

PMID41213296
PMCPMC12602009

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