Akademik Veri Yönetim Sistemi
Bone and Joint Open, cilt.6, sa.11, ss.1436-1445, 2025 (ESCI, Scopus)
Aims Heterotopic ossifcation (HO) is a recognized complication following periacetabular osteotomy (PAO), but its patterns, incidence, and clinical relevance remain poorly defned. The commonly used Brooker classifcation, developed for total hip arthroplasty, is not fully applicable to HO after PAO. This study aimed to propose a new classifcation system specifc to HO after PAO, evaluate its clinical relevance, and report the cumulative probabilities of radiological and symptomatic HO. Methods This retrospective study included 643 patients who underwent PAO between January 2006 and July 2024. A total of 308 patients (47.9%) had concomitant arthroscopic procedures. Radiographs were analyzed to identify HO using both the Brooker classifcation and a newly developed system. The cumulative probabilities of radiological and symptomatic HO were calculated using Kaplan-Meier analysis. Diference of variables between patients with and without HO was analyzed. Receiver operating characteristic (ROC) curve analysis was used to compare the predictive performance of the two classifcation systems. Results The cumulative probabilities of radiological and symptomatic HO at fve years post-PAO were 30.4% and 3.8%, respectively. The probabilities were 41.9% in males and 29.2% in females. Four patients (2.8%) required surgical excision of HO, all classifed as type 3 or 4 under the new system. The ROC analysis demonstrated superior predictive performance for the new classifcation system (AUC = 0.928) compared to the Brooker classifcation (AUC = 0.697; p = 0.007). No signifcant diferences were found between the patients with and without HO in terms of age, sex, concomitant arthroscopic procedures, or receiving prophylaxis in addition to low-dose aspirin. Conclusion This study highlighted the cumulative probabilities of HO following PAO and introduced a new classifcation system that improved clinical relevance and predictive accuracy. These fndings have provided insights into the incidence and management of HO after PAO, and laid the groundwork for standardized reporting and future research.