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Purpose <p>Heterotopic ossification (HO) is common following acetabular surgery. Evidence comparing external beam radiation (XRT) and nonsteroidal anti-inflammatory drugs (NSAIDs) for HO prophylaxis remains conflicting. This study evaluated changes in XRT utilization during the COVID-19 pandemic and compared the efficacy of XRT versus NSAIDs.</p> Methods <p>A retrospective review was conducted of 180 patients undergoing open acetabular fracture fixation at a level 1 trauma center from 2018 to 2021. High-risk patients received XRT or indomethacin if XRT was declined. Outcomes included prophylaxis method, severe (Brooker 3 or 4) HO, and HO resection.</p> Results <p>XRT utilization decreased significantly during the pandemic (74.3% vs. 28.0%, <i>P</i> &lt; 0.001). While severe HO rates remained similar (7.1% with XRT and 9.9% with NSAIDs) (<i>P</i> = 0.498), the only three HO resections were in the NSAIDs cohort.</p> Conclusion <p>Despite reduced XRT use during COVID-19, HO outcomes were unchanged, suggesting both XRT and NSAIDs are effective prophylaxis options.</p>

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Reduction in utilization of radiation for heterotopic ossification prophylaxis following acetabular surgery during the COVID-19 pandemic

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月22日

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  • Johnathan W. Riley,
  • Isaac J. Spears III,
  • Rowdy C. Lee,
  • Julian C. Clark II,
  • Cole Debevec,
  • Josny Thimothee,
  • Scott Weathersby,
  • Priyanka V. Nehete,
  • Peter N. Mittwede,
  • Patrick F. Bergin

摘要

Purpose

Heterotopic ossification (HO) is common following acetabular surgery. Evidence comparing external beam radiation (XRT) and nonsteroidal anti-inflammatory drugs (NSAIDs) for HO prophylaxis remains conflicting. This study evaluated changes in XRT utilization during the COVID-19 pandemic and compared the efficacy of XRT versus NSAIDs.

Methods

A retrospective review was conducted of 180 patients undergoing open acetabular fracture fixation at a level 1 trauma center from 2018 to 2021. High-risk patients received XRT or indomethacin if XRT was declined. Outcomes included prophylaxis method, severe (Brooker 3 or 4) HO, and HO resection.

Results

XRT utilization decreased significantly during the pandemic (74.3% vs. 28.0%, P < 0.001). While severe HO rates remained similar (7.1% with XRT and 9.9% with NSAIDs) (P = 0.498), the only three HO resections were in the NSAIDs cohort.

Conclusion

Despite reduced XRT use during COVID-19, HO outcomes were unchanged, suggesting both XRT and NSAIDs are effective prophylaxis options.