Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Jul 22;5(7):e21.00096.
doi: 10.5435/JAAOSGlobal-D-21-00096.

Relatively Low Rate of Heterotopic Ossification Following Primary Total Knee Arthroplasty: A Systematic Review and Meta-analysis

Ioannis Gkiatas  1 , William Xiang, Theofilos Karasavvidis, Eric N Windsor, Michael-Alexander Malahias, T David Tarity, Peter K Sculco
Affiliations
Meta-Analysis

Relatively Low Rate of Heterotopic Ossification Following Primary Total Knee Arthroplasty: A Systematic Review and Meta-analysis

Ioannis Gkiatas et al. J Am Acad Orthop Surg Glob Res Rev. .

Abstract

Background: Heterotopic ossification (HO) is abnormal growth of ectopic bone and negatively affects the outcomes after total knee arthroplasty (TKA). This systematic review and meta-analysis were performed to characterize the prevalence and severity of HO after primary TKA.

Methods: A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Patient demographics, publication year, and HO prevalence after a primary TKA were recorded. A meta-analysis was performed to determine the overall prevalence of HO formation, and a subanalysis compared the studies published in different timeframes to determine whether a temporal effect exists for HO prevalence.

Results: Two thousand nine hundred eighty-eight patients underwent primary TKA across the included studies. Fourteen percent of patients (9% to 20%; I2: 93.68%) developed HO postoperatively during a mean follow-up of 40.1 months (11 to 108 months). HO rates seemed to decrease in studies published in more recent years, with a pooled HO prevalence of 5% (0% to 13%; I2: 92.26%) among studies published in the past 15 years compared with 18% (12% to 25%; I2: 92.49%) among studies published before then.

Conclusion: Although studies reported a relatively low overall rate of HO after a primary TKA, the absence of a single, standardized classification system precludes the comparisons of HO severity between studies. Overall, HO prevalence seems to have decreased over time, likely reflecting the changes in perioperative medication protocols.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow chart diagram.
Figure 2
Figure 2
Forest plot depicting the overall prevalence of heterotopic ossification after primary total knee arthroplasty.
Figure 3
Figure 3
Forest plot depicting the prevalence of heterotopic ossification after primary total knee arthroplasty, stratified by articles published in the past 15 years compared with those published before then.
See this image and copyright information in PMC

References

    1. Meyers C, Lisiecki J, Miller S, et al. : Heterotopic ossification: A comprehensive review. JBMR Plus 2019;3:e10172. - PMC - PubMed
    1. Chen J, Wang X, Bai W, Shen X, Yuan W: Prevalence of heterotopic ossification after cervical total disc arthroplasty: A meta-analysis. Eur Spine J 2012;21:674-680. - PMC - PubMed
    1. Zhu Y, Zhang F, Chen W, Zhang Q, Liu S, Zhang Y: Incidence and risk factors for heterotopic ossification after total hip arthroplasty: A meta-analysis. Arch Orthop Trauma Surg 2015;135:1307-1314. - PubMed
    1. Bemenderfer TB, Davis WH, Anderson RB, et al. : Heterotopic ossification in total ankle arthroplasty: Case series and systematic review. J Foot Ankle Surg 2020;59:716-721. - PubMed
    1. Liu EY, Hildebrand A, Horner NS, Athwal GS, Khan M, Alolabi B: Heterotopic ossification after total elbow arthroplasty: A systematic review. J Shoulder Elbow Surg 2019;28:587-595. - PubMed

MeSH terms