Does a plastic drape reduce incidence of heterotopic ossification after hip resurfacing?

Background: High rates of heterotopic ossification have been associated with hip resurfacing as compared to THA. Bone debris from femoral head reamings is cited as one of the risk factors linked to increased rates of heterotopic ossification.

Questions/purposes: We therefore asked whether (1) the incidence of heterotopic ossification differed with and without the use of a plastic drape used to collect bone debris and (2) any of a number of variables (age, gender, diagnosis, previous hip surgery, operative time, and blood loss) related to the occurrence of HO.

Methods: We retrospectively reviewed 136 hip resurfacings performed using one of two techniques: Group 1 contained 64 hip resurfacings performed using a sterile drape around the femoral neck while reaming the femoral head to collect bone debris; Group 2 contained 72 hip resurfacings carried out with manually removing bone debris and utilizing a pulse lavage. Data were collected with respect to diagnosis, gender, previous surgery, postoperative complications, operative time, and blood loss to rule out confounding variables. The amount of heterotopic ossification was measured radiographically in hips after undergoing resurfacing arthroplasty. The minimum followup was 6 months (mean, 15 months; range, 6-27 months).

Results: No patient had heterotopic ossification of clinical importance and none had resection of the heterotopic ossification. Group 1 had a lower overall incidence of minor heterotopic ossification (32%) than Group 2 (58%). Risk factors linked to heterotopic ossification include male gender and operative time.

Conclusions: The use of a plastic drape to collect bone debris from femoral head reamings decreased the incidence of heterotopic ossification in resurfacing arthroplasty of the hip.