Early Resection of Heterotopic Ossification after Total Hip Arthroplasty: A Review of the Literature

Early excision of heterotopic ossification was performed in 8 patients at an average of 10.2 months after total hip arthroplasty. All patients received a single irradiation dose of 7Gy the day before the operation, followed by oral indomethacin (3x25mg/day) for six weeks. Continuous passive mobilization under epidural anesthesia was started immediately post-operatively. At an average follow-up of 2 years none of them had radiographic or clinical evidence of recurrence. Consequently we recommend resection as soon as there are severe clinical implications, even when bone scans indicate immaturity of the heterotopic ossification and provided that the resection is combined with proper non-surgical treatment consisting of irradiation and oral indomethacin and immediate extensive rehabilitation program.