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Review Question - QID 3253

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QID 3253 (Type "3253" in App Search)
A 55-year-old patient is scheduled for total knee arthroplasty. A radiograph is provided in Figure A. Each of the following are risk factors for heterotopic ossification EXCEPT?
  • A

Incorrect sizing of femoral and/or tibial components

58%

1467/2541

Male gender

11%

282/2541

Obesity

17%

431/2541

History of trauma

3%

64/2541

Presence of preoperative osteophytes (hypertrophic arthrosis)

11%

283/2541

  • A

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Heterotopic bone ossification (HO) following TKA has not been associated with valgus knee deformity. HO formation can be noted both after a THA and TKA, but unlike the hip, it rarely becomes a clinical problem in the knee. The overall incidence of HO after TKA varies greatly among published studies, ranging from 15-50%.

In the study by Dalury et al, they noted a 15% HO incidence. Among those with HO, 95% had osteoarthritis and 5% had a history of inflammatory arthritis. In their study, obese and male patients also had a higher incidence of developing post-operative HO.

Toyoda et al. showed a significantly higher rate of HO in patients with osteoarthritis and pre-operative osteophyte formation (hypertrophic arthrosis).

Overall, the significant risk factors include hypertrophic arthrosis (often seen with trauma), male gender, and obesity.

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