Follow-up/Toxicity

Question 1

What are the rates of increased wound-healing complications after RT for HO prophylaxis?

Answer 1

RT for HO prophylaxis has not been associated with an increased incidence of wound-healing complications.

Question 2

Is there an increased risk of nonfixation of cementless implants after RT for HO prophylaxis?

Answer 2

No. There is not an increased risk of nonfixation of cementless implants after RT for HO prophylaxis based on multiple studies. (Seegenschmiedt M et al., IJROBP 2001) Animal studies have shown a transient decrease in force required to remove an implant after RT, but this difference resolved by wk 3. (Konski A et al., IJROBP 1990)

Question 3

What is the rate of RT-induced tumor after RT for HO prophylaxis?

Answer 3

Rates of RT-induced tumor after RT for HO prophylaxis appear to be low. There are at least 2 case reports of RT-induced tumors after RT for HO prophylaxis. (Farris M et al., Radiat Oncol 2012; Mourad et al., PRO 2012) The rarity is thought to be d/t the use of low doses of RT as well as typically older age of the pt population. As RT is employed for younger pts, this risk is worth considering.