Myositis ossificans as a complication of hamstring autograft harvest for open primary anterior and posterior cruciate ligament and posterolateral corner reconstruction

Abstract

Post-traumatic myositis ossificans is a benign condition of heterotopic ossification of unknown aetiology which typically is related to trauma from a single blow or repeated episodes of microtrauma. A case of myositis ossificans that developed after hamstring autograft harvest for an open cruciate ligament and posterolateral corner reconstruction is described, a previously unrecognised complication of this procedure.

Modern synthetic material is a safe and effective alternative for medial patellofemoral ligament reconstruction

“…They found that mean Kujala score improved from 57 ± 8.4 pre-operatively to 84.3 ± 10.2 in the post-operative period, which showed results comparable to our study group using FT [4]. The Tegner score in their cohort also showed a significant improvement from 3.9 [4][5][6] pre-operatively to 5.7 [5][6][7]9] post-operatively, indicating that patients experienced recovery sufficient enough to return to a good level of exercise [4]. LARS R6x400 synthetic ligament is large and bulky and carries a significantly great cost compared to FT. MPFL is a superficial structure, and the volume effect of LARS ligament could negatively impact patient's experience.…”

“…Using the Crosby and Insall grading system [8], they found only one knee of poor quality, while the remaining 29 were assessed as either good or excellent. However, their surgical fixation technique used a staple which led to significant levels of post-operative pain at the staple site 16) 84 ( 15) 82 ( 12) 83 ( 16) 84 (18) Lysholm score 83 (9) 81 ( 18) 80 ( 15) 80 ( 9) 80 ( 11) 78 ( 12) SF-12 score 63 ( 15) 64 ( 18) 68 ( 13) 66 ( 8) 67( 9) 66(10) Tegner 6 (range 2-8) 6 (range 2-8) 6 (range 3-9) 6 (range 3-9) 6 (range 3-9) 6 (range [3][4][5][6][7][8][9] in 41% of patients [17]. In contrast to the use of knotless suture anchors, it did not lead to any post-operative pain reported by this cohort.…”

Pronounced Heterotopic Ossifications after Traumatic Hamstring Rupture: Is an Ossification Prophylaxis Useful?

“…Costopoulos et al konnten eine signifikant niedrigere Anzahl an HO nach Bizepssehnenrefixation nachweisen unter Gabe von Indomethacin im Vergleich zur Kontrollgruppe 15 . In der Literatur finden sich nur einzelne Fallberichte oder kleinere Studien zu HO nach Ruptur der ischiokruralen Muskulatur 4 , 6 , 16 , 17 , 18 . Ziel dieser Falldarstellung ist es, ein Bewusstsein für HO nach Verletzungen der ischiokruralen Muskulatur zu schaffen mit der Frage, ob eine Ossifikationsprophylaxe mittels NSAR während der Therapie erwogen werden sollte.…”

“…Costopoulos et al demonstrated a significantly lower incidence of HO after biceps tendon reattachment with use of indomethacin compared with the control group 15 . In the literature there are only isolated case reports or small-scale studies of HO after rupture of the hamstring muscles 4 , 6 , 16 , 17 , 18 . The aim of this case presentation is to create awareness of HO after hamstring injury and ask whether ossification prophylaxis by means of NSAIDs should be considered during the treatment.…”