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Heterotopic bone formation following total shoulder arthroplasty
P Kjaersgaard-Andersen1, L H Frich, J O Søjbjerg
1Orthopaedic Hospital, University of Aarhus, Denmark.
The Journal of Arthroplasty
|January 1, 1989
Summary
Heterotopic bone formation is common after total shoulder replacement, affecting 45% of patients. While often not disabling, severe cases can limit shoulder movement, particularly in men and osteoarthritis patients.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Musculoskeletal Research
Background:
- Heterotopic ossification (HO) is the formation of bone in non-skeletal tissues.
- Post-arthroplasty HO can lead to joint stiffness and pain.
- Understanding HO incidence and impact after shoulder replacement is crucial for patient outcomes.
Purpose of the Study:
- To determine the incidence and location of heterotopic bone formation after Neer Mark-II total shoulder arthroplasty.
- To assess the correlation between HO and shoulder pain, range of motion, and patient demographics.
- To evaluate the clinical significance of HO following total shoulder replacement.
Main Methods:
- Retrospective analysis of 58 Neer Mark-II total shoulder replacements.
- Radiographic evaluation for ectopic ossification one year post-surgery.
- Correlation analysis with patient pain levels, range of active elevation, and pre-existing conditions (osteoarthritis, sex).
Main Results:
- 45% of patients developed ectopic ossification one year after surgery.
- 10% of cases showed ossification bridging the glenohumeral and/or glenoacromial spaces.
- No correlation found between HO and shoulder pain.
- Grade III HO was associated with limited active elevation.
- Male sex and osteoarthritis were significant risk factors for HO development.
Conclusions:
- Heterotopic bone formation is a frequent complication of total shoulder arthroplasty.
- Disabling heterotopic ossification appears to be rare, despite its high incidence.
- Risk factors include male sex and osteoarthritis, warranting further investigation and potential preventative strategies.