Heterotopic Ossification of the Patellar Tendon Following Intramedullary Nailing of the Tibia

Local application of a collagen type I/hyaluronate matrix and growth and differentiation factor 5 influences the closure of osteochondral defects in a minipig model by enchondral ossification

“…In addition, if rhGDF-5 had been effective outside the osteochondral defect for ectopic bone formation, we would have expected much better bone regeneration in the osteochondral defects themselves, which were filled directly with the growth factor carrier. Many articles were published, describing heterotopic ossification either after knee arthroplasty (Rader et al 1997;Barrack et al 2002;Iorio and Healy 2002;Toyoda et al 2003;Dalury and Jiranek 2004), knee ligament reconstruction (Patton and Tew 2000) or after retrograde nailing of femur fractures (Gosselin et al 1993;Horne and Blue 1999). One reason for the occurrence of heterotopic ossifications after opening the bone marrow from inside a joint is thought to be the "seeding" of bone marrow stem cells, which may lead to ectopic bone formation within the joint capsule, the surrounding muscles or the patellar tendon.…”

Patellar tendon ossification after partial patellectomy: a case report

“…Whenever reported, it is usually associated with conditions such as conservatively treated sleeve fractures of tibial tuberosity [1], total patellectomy during arthroplasty [2], intramedullary nailing of tibial fractures [3], anterior cruciate ligament reconstruction with patellar tendon autograft [4], and knee injury without fracture [5]. …”

A rare case of intra-articular heterotopic ossification of knee following intra-medullary nailing of fracture tibia in a patient with fat embolism

“…10 Excision of heterotopic bone is an option, but only after full maturation has occurred or else recurrence is inevitable. 11 After surgery, bisphosphonates may be prescribed to prevent further recurrence. 12 However, no therapies have been proven to be of benefit in prevention or arrest of development of HO in critical care patients.…”

“…8,9 Few cases of HO of the ligamentum patellae after intramedullary nailing of the tibia have been reported in literature. [10][11][12] However, till date there have been no reported cases of intra-articular HO in the knee involving the entire retropatellar fat pad and ligamentum patellae following intramedullary nailing of a tibial shaft fracture in the setting of fat embolism. In symptomatic HO of knee, excision of HO mass may be required to improve joint mobility.…”