Heterotopic ossifications: role of radiotherapy as prophylactic treatment

Numerous nonmalignant diseases can be treated with radiation therapy (RT). Among them, Heterotopic Ossification (HO) is a benign condition resulting from several causes that can be successfully managed with ionizing radiation. More often seen in the hip area after major surgical procedures, HO is of major concern as it can lead to functional disorders, pain and even to joint ankylosis. We retrospectively analyzed the outcome of therapeutic irradiation for the prevention of HO in 14 patients treated in our hospital between 2005 and 2011. All patients were irradiated with a dose ranging from 7 to10 Gy in a single fraction for prevention of HO after surgery. After a median follow up of 126 months (range 96 – 156 months) none of our patients developed HO. Impaired wound healing or other post surgery complications like trochanteric nonunion were not observed. A single fraction of RT seems to be a sufficient, cost effective and safe treatment regimen. In our study we report excellent results as none of our patients developed HO.

show abstract

“…They found that a single fraction of 7 Gy showed excellent results as 76% of patients experienced complete response. 19 …”

Section: Discussionmentioning

confidence: 99%

Radiation therapy for the prevention of heterotopic ossification: Efficacy and toxicity of single fraction radiotherapy

Georhakopoulos¹,

Kouloulias²,

Kougiountzopoulou³

et al. 2020

Orthop Rev (Pavia)

View full text Add to dashboard Cite

show abstract

“…Redda, retrospectively analyzed 30 patients after pre-or postoperative EBRT and obtained complete responses in 23 patients with excellent results in terms of joint mobility (the majority of patients received single fraction EBRT of 700 cGy) [2]. The use of radiotherapy as a prophylactic strategy is well established on the literature, and seems an efficient way of preventing the re-formation of ectopic bone, when delivered immediately before or after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…d) Radiographic ankylosis. The latter two are clinically symptomatic leading to motion impairment at the involved joint, pain and rarely to inflammatory signs like warmth, swelling and local erythema [2,3,9]. When HO causes symptoms it may decrease patient's quality of life in a meaningful manner.…”

Section: C)mentioning

confidence: 99%

“…External beam radiation therapy (EBRT) is frequently delivered in a single fraction of 700-800 cGy within 4h before surgery in the preoperative setting or within 72h from the end of surgery when applied postoperatively. Studies didn't find any difference on efficacy of prophylactic radiotherapy given before or after surgery, and rates of 77-90% of complete response has been reported [2,3,12,13]. DEGRO practical guidelines recommends a singlefraction dose of 700-800 cGy or fractionated radiation with five fractions of 350 cGy for HO prophylaxis [3].…”

Section: C)mentioning

confidence: 99%

“…Heterotopic ossification (HO) is an abnormal process that leads to the formation of lamellar bone in soft tissue, such as muscle, nerves or connective tissues [1][2][3][4]. There are some risk factors namely male gender, pre-existing ipsi-or contralateral HO, ankylosing spondylitis (Bekhterev's disease), disseminated idiopathic hyperostosis of the skeleton (Forestier disease), osteoarthritis and others [3,5].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Radiotherapy as Prophylactic or Sole Treatment of Heterotopic Ossifications - About Two Case Reports

Ponte

Rolim

Silva

et al. 2019

BJSTR

View full text Add to dashboard Cite

Heterotopic ossification (HO) is a rare condition usually related to trauma or neurologic damage. It can affect all bone joints but is more frequent at the hip, particularly following total hip arthroplasty. This condition leads to significant impairment of life quality due to ectopic bone formation which causes functional loss. Here we describe two cases of patients presenting symptomatic HO classified as Brooker III following total hip replacement. One of them was treated prophylactically with external beam radiation, few hours before surgery for prosthesis revision. The other one, received radiotherapy as sole treatment with the intent of symptoms palliation. During the follow-up visits, the first patient didn't show any HO recurrence and had a significant improvement of his symptoms, namely the claudication; the last one achieved a significant relief of pain and showed an improvement on his functional capability. These cases show the potential benefit of radiotherapy as prophylaxis or as sole treatment of symptomatic HO.

show abstract

Musculoskeletal Disorders

Mak

Wong

2023

Radiation Therapy of Benign Diseases

View full text Add to dashboard Cite

Heterotopic ossifications: role of radiotherapy as prophylactic treatment

Abstract: Our data confirm safety and efficacy of RT in preventing HO, especially in high-risk patients, preferring a single fraction of 7 Gy.

Cited by 8 publications

References 24 publications

Radiation therapy for the prevention of heterotopic ossification: Efficacy and toxicity of single fraction radiotherapy

Radiation therapy for the prevention of heterotopic ossification: Efficacy and toxicity of single fraction radiotherapy

Radiotherapy as Prophylactic or Sole Treatment of Heterotopic Ossifications - About Two Case Reports

Musculoskeletal Disorders

Contact Info

Product

Resources

About