TY - JOUR
T1 - Computerized tomography-based radiotherapy improves heterotopic ossification outcomes
AU - Mourad, Waleed F.
AU - Packianathan, Satya
AU - Ma, John K.
AU - Yang, Claus (Chunli)
AU - Shourbaji, Rania A.
AU - He, Rui
AU - Zhang, Zhen
AU - Kanakamedala, Madhava Rao
AU - Khan, Majid A.
AU - Mobit, Paul
AU - Katsoulakis, Evangelia
AU - Nabhani, Thomas
AU - Jennelle, Richard
AU - Russell, George V.
AU - Vijayakumar, Srinivasan
PY - 2013/11
Y1 - 2013/11
N2 - Purpose: To report the impact of computerized tomography (CT) based radiotherapy (RT) on heterotopic ossification (HO) outcomes. Methods: This is a single institution, retrospective study of 532 patients who were treated for traumatic acetabular fractures (TAF). All patients underwent open-reduction internal-fixation (ORIF) of the TAF followed by RT for HO prophylaxis. Postoperative RT was delivered within 72. h, in a single fraction of 7. Gy. The patients were divided into 2 groups based on RT planning: CT (A) vs. clinical setup (B). Results: At a median follow up of 8. years the incidence of HO was 21.6%. Multivariate regression analysis revealed that group (A) vs. (B) had HO incidence of 6.6% vs. 24.6% (p. <. 0.001), respectively. Furthermore, HO Brooker grade ≥. 3 was observed in 2.2% vs. 10.8% (p. =. 0.007) in group (A) vs. (B), respectively. Thus, the odds of developing HO and Brooker grades ≥. 3 were 4.7 and 4.5 times higher, respectively, in patients who underwent clinical setup. Conclusion: Our data suggest that using CT based RT allowed more accurate delineation of the tissues and better clinical outcomes. Although CT-based RT is associated with additional cost the efficacy of CT-based RT reduces the risk of HO, thereby decreasing the need for additional surgical interventions.
AB - Purpose: To report the impact of computerized tomography (CT) based radiotherapy (RT) on heterotopic ossification (HO) outcomes. Methods: This is a single institution, retrospective study of 532 patients who were treated for traumatic acetabular fractures (TAF). All patients underwent open-reduction internal-fixation (ORIF) of the TAF followed by RT for HO prophylaxis. Postoperative RT was delivered within 72. h, in a single fraction of 7. Gy. The patients were divided into 2 groups based on RT planning: CT (A) vs. clinical setup (B). Results: At a median follow up of 8. years the incidence of HO was 21.6%. Multivariate regression analysis revealed that group (A) vs. (B) had HO incidence of 6.6% vs. 24.6% (p. <. 0.001), respectively. Furthermore, HO Brooker grade ≥. 3 was observed in 2.2% vs. 10.8% (p. =. 0.007) in group (A) vs. (B), respectively. Thus, the odds of developing HO and Brooker grades ≥. 3 were 4.7 and 4.5 times higher, respectively, in patients who underwent clinical setup. Conclusion: Our data suggest that using CT based RT allowed more accurate delineation of the tissues and better clinical outcomes. Although CT-based RT is associated with additional cost the efficacy of CT-based RT reduces the risk of HO, thereby decreasing the need for additional surgical interventions.
KW - Acetabular fracture
KW - Computerized tomography
KW - Heterotopic ossification
KW - Radiation therapy
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U2 - 10.1016/j.bone.2013.08.001
DO - 10.1016/j.bone.2013.08.001
M3 - Article
C2 - 23938292
AN - SCOPUS:84882945829
SN - 8756-3282
VL - 57
SP - 132
EP - 136
JO - Bone
JF - Bone
IS - 1
ER -
