Heterotopic ossification after revision total knee arthroplasty

Robert L Barrack¹, Christopher S Brumfield, Cecil H Rorabeck

¹Department of Orthopaedic Surgery, Tulane University Health Sciences Center, New Orleans, LA 70112, USA. rbarrack@tulane.edu

Clinical Orthopaedics and Related Research

|November 20, 2002

Summary

Heterotopic ossification (HO) is common after revision total knee arthroplasty, affecting 56% of patients. Infection significantly increases HO risk, which is linked to lower functional scores.

Area of Science:

Orthopedic Surgery
Biomedical Engineering
Radiology

Background:

Revision total knee arthroplasty (TKA) is complex, with potential complications.
Heterotopic ossification (HO), the formation of bone in non-skeletal tissues, can impact outcomes.
Understanding HO incidence and risk factors in revision TKA is crucial for patient management.

Purpose of the Study:

To evaluate the incidence and grade of heterotopic ossification (HO) after revision total knee arthroplasty (TKA).
To identify risk factors associated with HO development in revision TKA patients.
To correlate HO presence and severity with functional outcomes.

Main Methods:

A consecutive series of revision TKA patients from two centers were assessed.
Radiographs were analyzed for HO using the Harwin et al. classification system.
Knee Society scores and patient demographics were collected preoperatively and postoperatively.

Main Results:

The incidence of HO increased from 23% preoperatively to 56% at a mean 30-month follow-up.
Infection was the only identified risk factor for HO (76% incidence vs. 47% in non-infected patients).
Patients with HO had lower average postoperative Knee Society scores and poorer functional performance, especially in stair climbing.

Conclusions:

Heterotopic ossification is a frequent complication following revision total knee arthroplasty.
Surgical site infection is a significant risk factor for HO development.
The presence of HO negatively impacts functional outcomes after revision TKA, necessitating further research into preventative strategies.

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Area of Science:

Background:

Purpose of the Study:

Main Methods:

Main Results:

Conclusions:

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