Thrombin Hemostatic Matrix Reduces Heterotopic Ossification in Acetabular Fractures Fixed Through the Kocher–Langenbeck Approach

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 using t-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 equ...
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research