Heterotopic Ossification of Bilateral Hips Post–COVID-19 and Prolonged Immobilization

Abstract

Case: A 43-year-old healthy man developed hip pain post–coronavirus disease 2019 (COVID-19) immobilization. Imaging confirmed bilateral bridging heterotopic ossification (HO) of the hips, Brooker Class IV. Bilateral HO caused functional arthrodesis (45° flexion: −20° internal rotation). Bilateral HO resection resulted in almost full mobility at 1-year follow-up (90° flexion; 30° internal rotation). Conclusion: Many cases of HO after immobilization for COVID-19 have been reported, but as far as we know, this is the first case report describing surgical intervention as an adequate treatment option for severe restricted mobility caused by HO due to COVID-19–induced prolonged immobilization. Caution and preoperative 3D planning are recommended of HO formation near neurovascular structures.