A 75-year-old woman develops Brooker Class III heterotopic ossification 6 months after total hip replacement through a direct lateral approach. She has restricted flexion to 70 degrees but is otherwise asymptomatic. What is the recommended management?
- A Observation and physiotherapy only ✓
- B Surgical excision with post-operative radiotherapy
- C Indomethacin for 6 weeks
- D Low-dose radiotherapy alone
Correct answer: A. Observation and physiotherapy only
Explanation
Brooker Class III heterotopic ossification without significant functional limitation is managed conservatively with observation. Excision is reserved for severe restriction (less than 50 degrees of flexion) or functional impairment. Prophylaxis with indomethacin or radiotherapy is used in the immediate postoperative period, not months later.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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