PROPHYLAXIS OF HETEROTOPIC OSSIFICATIONS AFTER HIP-ARTHROPLASTY - WITH THE RESULTS OF A RANDOMIZED DOUBLE-BLIND-STUDY OF ACEMETACIN VERSUS INDOMETHACIN

We examined the effect of NSAR in the prophylaxis of heterotopic ossif ications after hip arthroplasty. During a randomized doubleblind study 59 patients took Indometacin and 60 patients Acemetacin for three wee ks after the operation. All of them got a thrombosis prophylaxis with Heparin and a short term antibiotic prophylaxis. The range of ossifica tions was checked three months after the operation according to Arcq. The proportion of patients with no clinical symptoms (grade 0 or 1) wa s 92,3% in the indometacin group and 98,2% in the acemetacin group. Be cause of side effects (mainly gastrointestinal) 7 patients (11,9%) in the indometacin group and 5 patients (8,3%) in the acemetacin group st opped the study. In a previous study we had examined the effect of thr ombosis prophylaxis by Heparin on the heterotopic ossifications. These results could now be taken for comparison. According to these results the examined NSAR Indometacin and Acemetacin raised the group of low grade heterotopic ossifications. The higher grades (2 degrees and 3 de grees according to Arcq) were only be seen in less than 5%. That is wh y we recommend the NSAR (Acemetacin or Indometacin) generally after hi p arthroplasty as prophylaxis of heterotopic ossifications.