Abstract
Objective To evaluate the clinical efficacy of radiation therapy and non - steroid anti - inflammatory drugs ( NSAIDs ) in the treatment and prevention of heterotopic ossification ( HO ) after hip surgery. Methods According to Cochrane systematic evaluation method, PubMed, EMBase and CENTRAL were retrieved by computer to collect randomized controlled trials ( RCTs ) on the comparison of radiation therapy and NSAIDs in the treatment and prevention of HO after hip surgery ( THA or ORIF ) . The quality of the involved literatures was evaluated according to the standard of Cochrane - Collaboration and meta analysis was conducted after data extraction. Results Eight articles with a total of 1 550 patients were involved into the stud-y. Meta analysis showed that: ( 1 ) The general condition of HO between the radiation group and NSAIDs group showed no statistically significant difference [ RR =0. 81, 95% CI ( 0. 51, 1. 30 ), P =0. 39 ] . ( 2 ) After THA and ORIF, the HO between the radiation group and NSAIDs group both showed no statistically significant differences [ RR =0. 90, 95% CI ( 0. 44, 1. 85 ), P=0. 77; RR=0. 07, 95% CI (0.48, 1.02), P =0. 07] . (3) According to Brooker grading, the HO of the two groups among patients of Brooker - 1 level [ RR = 0. 81, 95% CI ( 0. 61, 1. 08 ), P = 0. 16 ], Brooker - 2 level [ RR = 0. 75, 95% Cl(0.46, 1.23), P=0.26], Brooker -3 level [ RR = 1. 20, 95%Cl(0.77, 1.87), P = 0. 43 ] and Brooker - 4 level [ RR = 0. 20, 95% CI ( 0. 02, 1. 68 ), P = 0. 14 ] all showed no statistically significant differences. ( 4 ) After intervention, the overall complication between the two groups showed no statistically significant difference [ RR =0.71, 95% CI (0.30, 1. 67 ), P =0. 43 ] . ( 5 ) The incision problems between the two groups after intervention also showed no statistically significant difference [RR = 1.71, 95%CI (0.95, 3.05), P=0.07] .Conclusion The efficacies of radiation therapy and NSAIDs are similar in the treatment and prevention of HO after hip surgery. NSAIDs can be adopted for patients without contraindication and having ordinary financial abilities, but they can turn to radiation therapy when necessary.关键词
骨化,异位性/髋骨折/关节成形术,置换,髋/非甾体类抗炎药/放射疗法/Meta分析Key words
Ossification, heterotopic/ Hip fractures/ Arthroplasty, replacement, hip/ Non - steroidal anti - inflammatory drugs/ Radiotherapy/ Meta - analysis分类
医药卫生
