Indomethacin vs. radiation for prophylaxis against heterotopic ossification

Journal/Book: Aus: Rehab in Review Vol.6 No.S 1998. Physikalische Medizin Heft 5 8. Jahrgang Oktober 1998 M 59. 1998;

Abstract: Moore K. D. et al.: Indomethacin versus radiation therapy for prophylaxis against heterotopic ossification in acetabular fractures: a randomized prospective study. J. Bone Joint Surg. 80-B(2) (1998) 259-263 Previous studies have demonstrated the efficacy of both indomethacin and radiation therapy in preventing the occurrence of heterotopic ossification (HO) among those at risk. This study sought to compare these two methods of Intervention in patients with acetabular fractures. A total of 75 adult patients with acetabular fractures were studied. Patients were randomized to one of two treatment groups. Group A was exposed to radiation at 800 cGy within three days of surgery while Group B received 25 mg of indomethacin the evening before surgery and then three times a day for six weeks. Radiographs were taken at 1.5 3 6 12 24 36 and 48 months after the surgery. Follow-up clinical exam occurred between six and 48 months (average six months). Nine percent of the patients in the radiation group and 18 % of those in the indomethacin group developed grade III HO. The differences between the groups were not however statistically significant. In addition no significant difference was found between the two groups in level of complications noted. The authors compare the two interventions by cost and note a significant cost savings with indomethacin. Conclusion: This study of patients undergoing surgery for acetabular fractures suggests no significant difference in the development of HO between the groups receiving radiation treatment versus those receiving anti-inflammatory treatment using indomethacin. schö

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