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Child Orthopedics
Spine - Cervical
Spine - Lumbar
Spine - Thoracic

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I got heterotropic ossification after a total hip replacement. I'm still recovering from the hip surgery. What's the treatment for this new problem?

Heterotopic ossification (HO) or the overgrowth of bone is not uncommon after any trauma to the hip area. Total hip replacement tops the list. Doctors hope to find ways to tell who might get HO and how to prevent it. This would be much better than trying to treat it after it occurs. Right now, radiation therapy can be used to treat HO. Patients are understandably concerned about the possible side effects of radiation. Also the cost of this treatment can add up. Another option is the use of nonsteroidal anti-inflammatory drugs (NSAIDs).

There are many different kinds of NSAIDs. Researchers are trying to find out which one(s) work best. The newer NSAIDs have fewer side effects on the gut, a common problem with aspirin and other anti-inflammatory drugs. These newer NSAIDs are called COX-1 and COX-2 inhibitors.

It's not clear how COX-1 and 2 inhibitors work to prevent HO. Maybe they suppress bone formation by stopping early stages of inflammation that occur with bone growth. Or maybe there's a direct effect of the inhibitors on the base cells that form bone cells.

In some cases surgery is needed to cut the bone fragments out. This can damage the nearby muscle tissue and must be done carefully. Even with the best surgeon, problems can occur. Treatment often depends on how severe the problem is and how much it's bothering the patient. Check with your doctor about your case and see what's advised.


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