Prophylactic Radiotherapy of Hip Heterotopic Ossification: A Narrative Mini Review

Abstract

Evidence on prophylactic radiotherapy (RT) in hip heterotopic ossification (HO) is sparse and conflicting. The aim of this literature review was to collect and summarize the available data on RT efficacy in preventing hip HO. The results of this review show that RT is effective in the prevention of hip HO, albeit with large variability across series. Effective prophylactic RT requires optimal treatment fields and time intervals with surgery. On the contrary, there is no clear evidence on the optimal timing (post-operative versus pre-operative RT). Comparisons between prophylactic RT and use of non-steroidal anti-inflammatory drugs showed conflicting results, although most were in favor of RT. In conclusion, RT is an established prophylactic treatment for hip HO. However, optimal dose, technique and timing remain unclear, as does the usefulness of combining RT with drugs.

Keywords: Literature review; heterotopic ossification; hip; prophylaxis; radiotherapy; review.

Figure 1. Extensive heterotopic ossification of the right hip in a 55-yearold male patient with paralysis of the lower extremity. Computerized tomography: A: coronal reconstruction; B: sagittal reconstruction.