Prophylactic Radiotherapy for Prevention of Heterotopic Ossification After Periacetabular Fractures: A Review of Efficacy and Associated Conditions


Prophylactic radiotherapy (XRT) is a commonly used treatment to decrease heterotopic ossification (HO) in patients with traumatic hip injuries. We conducted a retrospective review of patients at risk for HO who underwent XRT. Of the patients reviewed, 27.3% developed radiographic HO, 11.2% developed symptoms, and 2.0% required resection surgery. Patients were divided into primary (n = 71) and secondary prophylaxis (n = 27) cohorts. In the primary group, 25.0% developed radiographic HO, 5.6% developed symptoms, and 0 required surgery. In the secondary cohort, 33.3% of patients developed new radiographic HO, and 25.9% were symptomatic: four had a Brooker score of 3, and three had a score of 4 (p = 0.03), and 7.4% required surgical resection. (Journal of Surgical Orthopaedic Advances 31(2):113–118, 2022)

Key words: heterotopic ossification, radiation therapy, prophylaxis, acetabular fracture

Joseph S. Geller, MD; Paul R. Allegra, MD; Crystal S. Seldon, MD; Benjamin O. Spieler, MD; Lara L. Cohen, MPH; Spencer W. Barnhill, MD; Samuel R. Huntley, MD MPH; Stuart Samuels, MD PhD; Lora Wang, MD; Derek Isrow, MD, PhD; Alberto De La Zerda, PhD; Aaron H. Wolfson, MD; Giselle Hernandez, MD; Fernando E. Vilella, MD and Raphael L. Yechieli, MD