Heterotopic Ossification

Naraghi, Fred F.; DeCoster, Thomas A.; Moneim, Moheb S.; Miller, Ronald; Rivero, Dennis P.

doi:10.3928/0147-7447-19960201-10

Cited by 85 publications

(6 citation statements)

References 57 publications

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“…It is commonly recognized as a complication after trauma, surgery, blast, spinal cord injury, and other stress damages ( Shimono et al, 2011 ; Regard et al, 2013 ; Ranganathan et al, 2015 ; Wang et al, 2016 ). Heterotopic ossification was first labeled as “paraosteoarthropathy” by French physicians Dejerne and Ceillier, being a consequence of traumatic paraplegia of patients during World War I, and was further observed among soldiers returning from Iraq and Afghanistan ( Naraghi et al, 1996 ; Forsberg et al, 2009 ; Potter et al, 2010 ; Forsberg et al, 2014 ). In severe cases, complete bony ankylosis as a result of HO is quite common, and more than 20% of patients appear overt dysfunction in soft-tissue, joint, or suffer from chronic pain; The HO morbidity of patients with traumatic brain injury almost reach 50% ( Vanden Bossche and Vanderstraeten, 2005 ; Balboni et al, 2006 ; Zhang et al, 2014 ; Xu et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Heterotopic Ossification: Clinical Features, Basic Researches, and Mechanical Stimulations

Mei

et al. 2022

Front. Cell Dev. Biol.

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Heterotopic ossification (HO) is defined as the occurrence of extraskeletal bone in soft tissue. Although this pathological osteogenesis process involves the participation of osteoblasts and osteoclasts during the formation of bone structures, it differs from normal physiological osteogenesis in many features. In this article, the primary characteristics of heterotopic ossification are reviewed from both clinical and basic research perspectives, with a special highlight on the influence of mechanics on heterotopic ossification, which serves an important role in the prophylaxis and treatment of HO.

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Section: Introductionmentioning

confidence: 99%

Heterotopic Ossification: Clinical Features, Basic Researches, and Mechanical Stimulations

Mei

et al. 2022

Front. Cell Dev. Biol.

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“…1 HO is diagnosed in 0.6% to 61.7% of patients after THA and 10% to 20% after brain and spinal cord injuries, causing joint pain and loss of function. [3][4][5][6][7][8][9] Surgical removal is the only treatment when ossification progresses; however, there is a risk of recurrence. Two common prophylactic therapies for HO are nonsteroidal anti-inflammatory drugs and radiation therapy.…”

Section: Introductionmentioning

confidence: 99%

“…HO is most commonly observed in gluteus medius muscle after surgical trauma such as total hip arthroplasty (THA), 2 although other affected sites include the elbow, knee, shoulder, and ankle 1 . HO is diagnosed in 0.6% to 61.7% of patients after THA and 10% to 20% after brain and spinal cord injuries, causing joint pain and loss of function 3–9 . Surgical removal is the only treatment when ossification progresses; however, there is a risk of recurrence.…”

Section: Introductionmentioning

confidence: 99%

Desloratadine inhibits heterotopic ossification by suppression of BMP2‐Smad1/5/8 signaling

Kusano

Nakatani

Ishiguro

et al. 2020

Journal Orthopaedic Research

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Heterotopic ossification (HO) is a pathological condition in which ectopic bone forms within soft tissues such as skeletal muscle. Human platelet‐derived growth factor receptor α positive (PDGFRα+) cells, which were proved to be the original cells of HO were incubated in osteogenic differentiation medium with Food and Drug Administration‐approved compounds. Alkaline phosphatase activity was measured as a screening to inhibit osteogenic differentiation. For the compounds which inhibited osteogenic differentiation of PDGFRα+ cells, we examined dose dependency of its effect using alizarin red S staining and its cell toxicity using WST‐8. In addition, regulation of bone morphogenetic proteins (BMP)‐Smad signaling which is the major signal of osteogenic differentiation was investigated by Western blotting to elucidate the mechanism of osteogenesis inhibitory effect by the compound. In vivo experiment, complete transverse incision of Achilles tendons in mice was made and mice were fed the compound by mixing with drinking water after operation. Ten weeks after operation, we assessed and quantified HO by micro‐computed tomography scan. Intriguingly, we discovered desloratadine inhibited osteogenic differentiation of PDGFRα+ cells using the drug repositioning method. Desloratadine inhibited osteogenic differentiation of the cells dose dependently without cell toxicity. Desloratadine suppressed phosphorylation of Smad1/5/8 induced by BMP2 in PDGFRα+ cells. In Achilles tenotomy mice model, desloratadine treatment significantly inhibited ectopic bone formation compared with control. In conclusion, we discovered desloratadine inhibited osteogenic differentiation using human PDGFRα+ cells and proved its efficacy using Achilles tenotomy ectopic bone formation model in vivo. Our study paved the way to inhibit HO in early clinical use because of its guaranteed safety.

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“…Heterotopic ossification (HO) is characterised as formation of lamellar bone in extraskeletal soft tissues. 1,2 The development of HO can basically be traced back to neuronal, genetic, traumatic and infectious causes. [3][4][5][6] HO is a known complication and may cause severe disabilities after total hip arthroplasty (THA) leading to pain and loss of mobility.…”

Section: Introductionmentioning

confidence: 99%

Diclofenac for prophylaxis of heterotopic ossification after hip arthroplasty: a systematic review

et al. 2020

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Background: Heterotopic ossification (HO) is defined as the formation of lamellar bone in extraskeletal soft tissues. HO can be a severe complication after hip arthroplasty but can possibly be prevented by postoperative treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or radiotherapy. Diclofenac is 1 of the most used drugs in HO prophylaxis because it is effective and long established. However, there is still no uniform therapy regimen in terms of duration, dose and side effect profile regarding the application of diclofenac in HO prevention. We have, therefore, conducted the first systematic review investigating diclofenac for HO prophylaxis after hip arthroplasty. The aim of this study is to assess the efficacy, dose and duration of diclofenac therapy in preventing HO after total hip arthroplasty (THA). Methods: According to the PRISMA Guidelines we performed a systematic literature search in EMBASE via Ovid, in MEDLINE via PubMed and in the Cochrane Library addressing all studies in English and German regarding the prophylaxis of HO with diclofenac after THA. We identified 731 potential studies and included 6 randomised controlled trials with 957 patients. Results: The studies were heterogeneous with regard to duration of therapy, dose, comparative group and follow-up period. The therapy duration ranged from 9 to 42 days, the applied diclofenac doses ranged from 75 mg to 150 mg daily. Patients treated with diclofenac showed a significant reduction in the total incidence of HO regarding to the Brooker Classification compared to placebo and no clinically relevant ossifications occured (Brooker III and IV). Conclusions: Diclofenac is efficacious in the prevention of HO and can be used routinely after THA. The existing data indicates that a minimum dose of 75 mg diclofenac per day started on the first postoperative day for a minimum of 9 days is needed to prevent HO with an acceptable incidence of side effects, such as gastrointestinal symptoms.

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Heterotopic Ossification

Cited by 85 publications

References 57 publications

Heterotopic Ossification: Clinical Features, Basic Researches, and Mechanical Stimulations

Heterotopic Ossification: Clinical Features, Basic Researches, and Mechanical Stimulations

Desloratadine inhibits heterotopic ossification by suppression of BMP2‐Smad1/5/8 signaling

Diclofenac for prophylaxis of heterotopic ossification after hip arthroplasty: a systematic review

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