Heterotopic Ossifications: General Survey for All Sites

Seegenschmiedt, M. H.; Micke, Oliver; Heyd, Reinhard

doi:10.1007/978-3-540-68943-0_18

Cited by 6 publications

(11 citation statements)

References 122 publications

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“…Preoperative extent of HO has previously been suggested as being the main risk factor for recurrence after excision [14], [15], [33], [34]. Stover et al followed 38 HO excisions of 18 patients with SCI [15].…”

Section: Discussionmentioning

confidence: 99%

“…Patients in class I are rarely symptomatic. The other limit, also highlighted by Seegenschmiedt et al, is that this classification cannot be transferred to other joints [14]. Since HO after CNS damage develops around joints of different sizes (hip, knee, shoulder elbow), the transposition of an assessment using the extent of HO in centimeters is difficult.…”

Section: Discussionmentioning

confidence: 99%

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The Impact of Preoperative Hip Heterotopic Ossification Extent on Recurrence in Patients with Head and Spinal Cord Injury: A Case Control Study

et al. 2011

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BackgroundThe preoperative Heterotopic Ossification (HO) extent is usually one of the main used criteria to predict the recurrence before excision. Brooker et al built a radiologic scale to assess this pre operative extent around the hip. The aim of this study is to investigate the relationship between the recurrence risk after hip HO excision in Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI) patients and the preoperative extent of HO.Methodology/Principal FindingsA case control study including TBI or SCI patients following surgery for troublesome hip HO with (case, n = 19) or without (control, n = 76) recurrence. Matching criteria were: sex, pathology (SCI or TBI) and age at the time of surgery (+/−4.5 years). For each etiology (TBI and SCI), the residual cognitive and functional status (Garland classification), the preoperative extent (Brooker status), the modified radiological and functional status (GCG-BD classification), HO localization, side, mean age at the CNS damage, mean delay for the first HO surgery, and for the case series, the mean operative delay for recurrence after the first surgical intervention were noted.Conclusions/SignificanceThe median delay for first HO surgery was 38.6 months (range 4.5 to 414.5;) for the case subgroup and 17.6 months (range 5.7 to 339.6) for the control group. No significant link was found between recurrence and operative delay (p = 0.51); the location around the joint (0.07); the Brooker (p = 0.52) or GCG-BD status (p = 0.79). Including all the matching factors, no significant relationship was found between the recurrence HO risk and the preoperative extent of troublesome hip HO using Brooker status (OR = 1.56(95% CI: 0.47–5.19)) or GCG-BD status (OR class 3 versus 2 = 0.67(95% CI: 0.11–4.24) and OR class 4 versus 2 = 0.79(95%CI: 0.09–6.91)). Until the pathophysiology of HO development is understood, it will be difficult to create tools which can predict HO recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Impact of Preoperative Hip Heterotopic Ossification Extent on Recurrence in Patients with Head and Spinal Cord Injury: A Case Control Study

et al. 2011

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“…Clinically suspected HO was confirmed objectively by ultrasonography and radiog-raphy examined by a qualified radiologist. The classification of HO was based on the clinical, ultrasonographical and radiographical results, regarding the system German CooperativeGroup on Radiotherapy on Benign Diseases 20.…”

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confidence: 99%

Symptomatic heterotopic ossification: incidence and risk factors of a musculoskeletal complication in a general Intensive Care Unit

et al. 2019

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Background: Heterotopic ossification is a musculoskeletal complication in patients in intensive care unit which expects to impair their mobility and quality of life after discharge. The aim of the study was to examine the incidence and the risk factors of heterotopic ossification in critically ill patients. Methods: One hundred-ninety seven consecutive patients evaluated through clinical and laboratory screenings for heterotopic ossification upon admission and discharge and 123 of them were eligible for the study. Symptomatic heterotopic ossification was confirmed to 9 patients (7.31%) by means of ultrasonography and radiography. Many risk factors examined by logistic regression such as age, admission of Glasgow Coma Scale score, length of stay in intensive care unit, duration of mechanical ventilation, duration in Venturi mask and in mask tracheostomy, days in coma, traumatic and non-traumatic brain injury, increased intracranial pressure monitoring, autonomic dysregulation and days in respiratory alkalosis. Results: The risk factors that predict heterotopic ossification were: age, duration of mechanical ventilation, respiratory alkalosis, days in coma, admission of Glasgow Coma Scale score, increased intracranial pressure monitoring, autonomic dysregulation, and non–traumatic brain injury. In multivariate analysis were found significant the autonomic dysregulation, the respiratory alkalosis, the increased intracranial pressure monitoring and the duration of mechanical ventilation (F=17.44, p<0.00).Conclusions: The incidence of symptomatic heterotopic ossification appears to be significant in a general intensive care unit. A few factors seem to predict the occurrence of it, confirming previous studies. Larger studies are needed to be done for better prevention and early identification of this frequent musculoskeletal complication in critical ill patients.

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“…The pathogenesis of HO is attributed to change of primitive cells in muscles into osteogenic cells due to a triggering factor like trauma. 4,5 Radionuclide bone scan is highly sensitive in the assessment of progression and maturation process of HO. Radionuclide bone scan is often positive 4 to 6 weeks earlier than the conventional radiographs.…”

mentioning

confidence: 99%

“…6,7 The early CT changes often include tissue edema, as well as the clear zonal structures of the early HO islets. 4 Management of HO includes surgery, radiotherapy, and medication. However, surgical excision is the definitive treatment option in those functionally disabled by the HO and is often performed in matured HO to prevent relapse.…”

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confidence: 99%

Heterotrophic Ossification in a Patient Suspected of Having Osteomyelitis

Hassan

Enayat

Mohammed

et al. 2012

Clinical Nuclear Medicine

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A 46-year-old man, with a history of bilateral amputations, presented with a long-standing chronic nonhealing wound at the left below-knee amputation, which was sustained after a crush injury. The patient was referred for a bone scan to exclude osteomyelitis of the left stump. The bone scan showed increased uptake in the left below-knee amputation stump, raising the possibility of an infection. However, SPECT/CT of this area confirmed the uptake to correspond to the heterotrophic ossification of the left below-knee stump and no evidence of osteomyelitis.

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Heterotopic Ossifications: General Survey for All Sites

Cited by 6 publications

References 122 publications

The Impact of Preoperative Hip Heterotopic Ossification Extent on Recurrence in Patients with Head and Spinal Cord Injury: A Case Control Study

The Impact of Preoperative Hip Heterotopic Ossification Extent on Recurrence in Patients with Head and Spinal Cord Injury: A Case Control Study

Symptomatic heterotopic ossification: incidence and risk factors of a musculoskeletal complication in a general Intensive Care Unit

Heterotrophic Ossification in a Patient Suspected of Having Osteomyelitis

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