Last reviewed: September 29, 2026

Usually not. It is common to see on X-rays after a hip replacement, but it rarely causes problems.

Heterotopic ossification is bone that forms in the muscles and soft tissue around the new joint, where bone does not normally grow. It usually shows up on X-rays in the first months after surgery. Most of the time it is a small amount that the patient never notices.

Only the more severe forms matter. When enough bone forms to bridge across the joint, the hip can become stiff and hard to move, and sometimes painful. In one large study, only this most severe form was linked to worse results, and even then pain was not clearly worse. Lesser amounts made no difference to how people felt.

It is more common in men, in people who have had it before, in people whose hip was fused or nearly fused before surgery, and after longer or repeat hip operations. The way the hip is approached during surgery also affects the risk.

It can be prevented. A few weeks of certain anti-inflammatory medicines after surgery, or a single low dose of radiation to the hip around the time of surgery, both lower the chance of it forming. Not all anti-inflammatory medicines worked equally well, and ibuprofen did not work in a large pooled analysis. Because both treatments have side effects, surgeons usually reserve them for people at higher risk.

When it does limit movement badly, the extra bone can be removed with surgery. This is usually done only once the bone has fully matured, which can take a year or more, and prevention is given again to stop it from coming back. Removal reliably improves movement, but relief of pain is less certain.

In general:

  • Tell your surgeon if you have had this before, after any operation.
  • A mention of it on an X-ray report is not, by itself, a reason to worry.
  • A hip that grows stiffer over the first months, rather than looser, is worth reporting.
  • Check with your surgeon before taking anti-inflammatory medicines after surgery, especially with stomach, kidney or bleeding problems or blood thinners.

Drafted with AI assistance from published sources, reviewed and edited by Babak Sheikh, MD.

Sources:

This is general information about what published research shows. It is not medical advice and it is not about your situation. Reading it does not create a doctor-patient relationship with me. I am a retired orthopedic surgeon and I do not see patients. Talk with your own doctor before changing anything about your care. If something feels suddenly or seriously wrong, get medical care promptly rather than waiting.

This page is provided as is. I make no guarantee that it is accurate, complete or current, and medical evidence changes. Use of it is at your own risk.

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