Journal article
Thrombin Hemostatic Matrix Reduces Heterotopic Ossification in Acetabular Fractures Fixed Through the Kocher-Langenbeck Approach
Journal of orthopaedic trauma, Vol.34(9), pp.451-454
09/01/2020
DOI: 10.1097/BOT.0000000000001783
PMID: 32815830
Abstract
Objective: To determine whether an injectable thrombin product [thrombin hemostatic matrix (THM)] at closure of a Kocher-Langenbeck approach reduces the risk of heterotopic ossification (HO) formation after an acetabular fracture. Design: Case control. Setting: Two Level 1 trauma centers. Patients: Patients with operatively treated acetabulum fractures fixed through Kocher-Langenbeck from 2013 to 2018. Intervention: Records were reviewed for demographics, history of traumatic brain injury, HO medication or radiation prophylaxis, THM (Surgiflo, Ethicon, Bridgewater New Jersey) administration, and length of follow-up. Radiographs were reviewed for dislocation, fracture, Letournel and Orthopaedic Trauma Association classifications, HO, and Brooker grade if applicable. Patients receiving HO prophylaxis (eg, nonsteroidal anti-inflammatory drugs and radiation) were excluded. Remaining patients were divided into 2 groups: THM administration (intervention) and no THM. Continuous variables were compared usingt-tests and categorical variables with chi-square or Fisher's exact tests. Main Outcome Measurements: Risk ratios for the association between HO occurrence and THM administration. Results: Three-hundred and twenty-eight acetabular fractures met inclusion criteria (126 intervention, 202 control) in patients with a mean age of 38.7 +/- 15.9 years; 62.2% were male, and 42.1% were African American. Traumatic brain injury and posterior dislocation rates were equivalent between groups (P= 0.505, 0.754, respectively). HO rate in the control group was 42.6% compared with 21.4% in the THM group (P< 0.001). Booker grade 3/4 in control group was 17.3% versus 3.2% in the THM group (P< 0.001). Patients receiving THM had a 50% reduced risk of HO (95% confidence interval 0.35-0.73) compared to those who did not; adjustment for age, gender, ethnicity, and traumatic brain injury did not meaningfully change the association (risk ratio 0.46; 95% confidence interval 0.29-0.73;P< 0.001). Conclusion: The use of a surgiflo product at closure of a KO approach may reduce the risk of HO formation by 50% after an acetabular fracture.
Details
- Title: Subtitle
- Thrombin Hemostatic Matrix Reduces Heterotopic Ossification in Acetabular Fractures Fixed Through the Kocher-Langenbeck Approach
- Creators
- Tyler Montgomery - University of Alabama at BirminghamJeffery Pearson - University of Alabama at BirminghamAbhinav Agarwal - University of Alabama at BirminghamCatherine Olinger - Campbell ClinicDevon Tobey - Campbell ClinicMichael Beebe - Campbell ClinicGerald McGwin - University of Alabama at BirminghamKyle Cichos - University of Alabama at BirminghamEllie Ghanem - University of Alabama at BirminghamClay Spitler - University of Alabama at BirminghamCandace Dubose - University of Alabama at BirminghamJonathan Quade - University of Alabama at Birmingham
- Resource Type
- Journal article
- Publication Details
- Journal of orthopaedic trauma, Vol.34(9), pp.451-454
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/BOT.0000000000001783
- PMID
- 32815830
- ISSN
- 0890-5339
- eISSN
- 1531-2291
- Number of pages
- 4
- Language
- English
- Date published
- 09/01/2020
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984303990202771
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