TABLE IV.
Prophylactic Options for Postoperative Heterotopic Ossification*
| Treatment Used in Study | Clinically Important Heterotopic Ossification† | Level of Evidence |
| Saudan et al.55 (2007) | I | |
| Celecoxib | 6/117 (5.1%) | |
| Ibuprofen | 16/123 (13.0%) | |
| Grohs et al.57 (2007) | I | |
| Rofecoxib | 3/46 (6.5%) | |
| Indomethacin | 0/50 (0.0%) | |
| Karunakar et al.50 (2006) | I | |
| Placebo | 13/62 (20.9%) | |
| Indomethacin | 9/59 (15.2%) | |
| Fransen et al.104 (2006) | I | |
| Placebo | 26/407 (6.4%) | |
| Ibuprofen | 11/391 (2.8%) | |
| Burd et al.66 (2001) | I | |
| Radiation therapy | 3/78 (3.8%) | |
| NSAIDs | 8/72 (11.1%) | |
| Kölbl et al.105 (1997) | I | |
| Radiation therapy | 1/188 (0.5%) | |
| NSAIDs | 2/113 (1.8%) | |
| Kölbl et al.37 (1997) | I | |
| Radiation therapy | 0/100 (0.0%) | |
| NSAIDs | 6/183 (3.3%) | |
| Beckmann et al.63 (2014) | III | |
| No treatment | 23/92 (25.0%) | |
| Naproxen | 11/196 (5.6%) | |
| Brunnekreef et al.54 (2013) | III | |
| Etoricoxib | 0/42 (0.0%) | |
| Le Duff et al.60 (2011) | III | |
| Indomethacin and 1000 mL saline solution jet lavage | 6/111 (5.4%) | |
| Indomethacin, radiation therapy, and 1000 mL saline solution jet lavage | 23/332 (6.9%) | |
| Indomethacin, radiation therapy, and 2000 mL saline solution jet lavage | 5/247 (2.0%) | |
| Indomethacin, radiation therapy, 2000 mL saline solution jet lavage, and debris drape | 5/294 (1.7%) | |
| Nunley et al.59 (2011) | III | |
| Aspirin | 1/151 (0.7%) | |
| Warfarin | 4/46 (8.7%) | |
| van der Heide et al.56 (2007) | III | |
| Placebo | 2/99 (2.0%) | |
| Indomethacin | 49/170 (28.9%) | |
| Rofecoxib | 0/42 (0.0%) |
*
Clinically important heterotopic ossification was determined to be Brooker score of III or IV by radiographic imaging. Drug names ending in -coxib are selective COX-2 inhibitors.
†
The values are given as the number of patients who developed heterotopic ossification divided by the total number in the treatment group.