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Heterotopic ossification (HO) prophylaxis after distal biceps repair
Udit Dave1, Jayanth Mosalakanti1, Pavan Guduri1
1School of Medicine, Tulane University, New Orleans, LA, USA.
JSES Reviews, Reports, and Techniques
|October 30, 2024
Summary
Heterotopic ossification (HO) after distal biceps repair may be reduced by indomethacin, but its routine use is not recommended due to limited efficacy and potential risks. Further research should explore other NSAIDs or no prophylaxis.
Area of Science:
- Orthopedic Surgery
- Pharmacology
Background:
- Heterotopic ossification (HO) is a complication of distal biceps repair, affecting limb function and patient outcomes.
- Current prophylaxis methods include nonsteroidal anti-inflammatory drugs (NSAIDs) and radiation therapy.
Purpose of the Study:
- To systematically review the literature and determine effective means of HO prophylaxis following distal biceps repair.
Main Methods:
- A systematic review adhering to PRISMA guidelines was conducted.
- Searched PubMed, Embase, and Cochrane Library for studies published after 1998.
- Included prospective randomized controlled trials and retrospective case-control studies comparing HO prophylaxis with no prophylaxis.
Main Results:
- Four studies met the inclusion criteria, all evaluating indomethacin; one also evaluated meloxicam.
- Two studies supported indomethacin for HO prophylaxis, one did not, and one found indomethacin and meloxicam similarly effective.
- No studies analyzed radiation therapy for HO prophylaxis.
Conclusions:
- Routine use of indomethacin for HO prophylaxis after distal biceps repair is not necessary due to limited efficacy and potential risks.
- Future studies should investigate other NSAIDs (e.g., meloxicam) or the absence of prophylaxis for both one- and two-incision repairs.
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