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Journal article
Comparing Options for Heterotopic Ossification Prophylaxis following Elbow Trauma: A Systematic Review and Meta-Analysis
Journal of hand and microsurgery, v 13(3), 189
01 Jul 2021
PMID: 34511838
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Introduction
Heterotopic ossification (HO) can be a potentially serious and devastating complication following traumatic injury to the elbow. HO prophylaxis options include nonsteroidal anti-inflammatory drugs (NSAIDs) and radiation therapy (RT) but neither has been proven more effective. The purpose of this review is to compare effectiveness and outcomes between NSAID and RT prophylaxis for HO about the elbow following a traumatic injury.
Materials and Methods
We performed a systematic review of PubMed and Cochrane Library for cases of HO prophylaxis following elbow trauma utilizing PRISMA guidelines to determine the most effective form of prophylaxis. Outcomes of interest included recurrence of HO, range of motion (ROM), and Mayo elbow performance index (MEPI). A total of 36 articles and 826 elbows of which 203 received RT and 623 received NSAID were identified and included in the final analysis.
Results
Rates of HO formation or recurrence following elbow trauma were similar between radiation and NSAID prophylaxis (15.6% vs. 22.2%, respectively
p
= 0.457). ROM was similar in flexion and extension arc (109.0 degrees in radiation vs. 112.8 in NSAIDs,
p
= 0.459) and in pronation and supination arc (118.9 degrees radiation vs. 134.7 degrees NSAIDs,
p
= 0.322). MEPI scores were 79.19 in the radiation group and 88.82 in the NSAIDs group at the final follow-up.
Conclusion
There is no statistical difference in HO development, recurrence, or final ROM between NSAIDs and RT prophylaxis following trauma to the elbow. We recommend the choice of modality based on patient characteristics, cost, and surgeon preference.
Level of Evidence
Level III.
Metrics
Details
- Title
- Comparing Options for Heterotopic Ossification Prophylaxis following Elbow Trauma: A Systematic Review and Meta-Analysis
- Creators
- Jeffrey M. Henstenburg - Rothman InstituteMatthew Sherman - Thomas Jefferson UniversityAsif M. Ilyas - Rothman Institute
- Publication Details
- Journal of hand and microsurgery, v 13(3), 189
- Publisher
- Thieme Medical and Scientific Publishers Private Ltd
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000603965900006
- Scopus ID
- 2-s2.0-85114782465
- Other Identifier
- 991021838263804721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery