Effects of ethylhydroxydiphosphonate (EHDP) on heterotopic ossification

Abstract

The effect of EHDP medication was studied in 25 patients in whom heterotopic ossifications around the hip (19 cases) and elsewhere were resected. EHDP seemed to have a favorable effect on prevention of reossification and on function, particularly when ectopic ossifications were resected after total hip replacement. In all the patients, EHDP administration postponed mineralization of osteoid.

Neurogenic heterotopic ossification in spinal cord injury

“…10,35,52,70 Mature NHO resembles normal bone, both histologically and radiologically. 71,72 and consists of cancellous bone with Haversian canals, cortex, blood vessels and bone marrow, although with a minor amount of hematopoesis. 34,36,39,48,73 According to Chalmers et al 74 three conditions must be met for the formation of ectopic ossi®cation: the presence of osteogenic percursor cells, an inducing agent, and a permissive environment.…”

Ectopic ossification in hip arthroplasty: A retrospective study of predisposing factors in 637 cases

“…The application of prophylaxis should be useful in males and in use who have developed heterotopic ossifications after a primary operation and who have to be operated on the contralateral or ipsilateral side. Possibly a hereditary aspect is also involved (Nollen 1986). …”

Nonsteroid anti-inflammatory drugs prevent the recurrence of heterotopic ossification after excision

“…Many different treatments have been applied to prevent the formation of heterotopic bone after THR and to prevent its recurrence after resection: The diphosphonate ethane-l-hydroxy-l,l-diphosphonate (EHDP) inhibits the mineralization of newly formed bone matrix, but when the medication is discontinued, mineralization occurs [13,20]. Local irradiation of the hip region has been reported to prevent recurrence of clinically significant heterotopic bone after excision of PHO [2,4].…”

“…The risk of recurrence after surgical removal of PHO is very high [6,9]. Various treatments have been proposed to prevent the recurrence of PHO after resection, such as diphosphonates [13,20], postoperative local irradiation [2,4], insertion of free-fat autografts [1,14], or nonsteroid anti-inflammatory drugs (NSAIDs) [9,15].…”