Myositis ossificans following forcible manipulation of the leg. A rabbit model for the study of heterotopic bone formation.

Michelsson, Jarl-Erik; Granroth, Gustav; Andersson, Leif C.

doi:10.2106/00004623-198062050-00017

Cited by 100 publications

(53 citation statements)

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“…When exactly this scavenging takes place (at the time of manipulation or of immobilization) is difficult to determine. 15 …”

Section: Discussionmentioning

confidence: 99%

“…15 All procedures were approved by and performed in accordance with the Institutional Animal Care and Use Committee (ref. ECP 03/48).…”

Section: Methodsmentioning

confidence: 99%

“…34 Michelsson and colleagues already showed that the combination of immobilization and manipulation is the most important trigger of HO. 15,35 These factors are present in patients with spinal cord injuries, brain injuries, severe burns, or severe multiple injuries treated with, for example, arthroplasty.…”

Section: Disuse Phenomenonmentioning

confidence: 99%

See 2 more Smart Citations

Free radical scavengers are more effective than indomethacin in the prevention of experimentally induced heterotopic ossification

Bossche

Maele

Wojtowicz

et al. 2006

Journal Orthopaedic Research

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The pathogenesis of heterotopic ossification is still unclear and the preventive therapies are usually insufficient. The present study was designed to investigate the possible preventive effect of free radical scavengers on the development of experimentally induced heterotopic ossification in a rabbit model and to compare free radical scavengers with indomethacin to determine whether they act synergistically. A standard immobilization-manipulation model was used to induce heterotopical ossification in the hind legs of 40 1-year-old female New Zealand albino rabbits. The animals were divided into four groups and received daily either placebo, a free radical scavenger cocktail [allopurinol and N-acetylcysteine (A/A)], indomethacin or the combination of A/A and indomethacin in a randomized double-blind fashion. Every 4 days an X-ray was taken and the thickness and length of new bone formation was measured at the thigh. A marked statistically significant difference was found between the four groups. In the groups that received A/A, either alone or combined with indomethacin, an inhibition of bone growth, both in thickness and in length was demonstrated. In this experimental model free radical scavengers had a superior inhibitory effect on heterotopic ossification than indomethacin. Free radicals could play an important role in the pathogenesis of heterotopic ossification. ß

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“…When exactly this scavenging takes place (at the time of manipulation or of immobilization) is difficult to determine. 15 …”

Section: Discussionmentioning

confidence: 99%

“…15 All procedures were approved by and performed in accordance with the Institutional Animal Care and Use Committee (ref. ECP 03/48).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Free radical scavengers are more effective than indomethacin in the prevention of experimentally induced heterotopic ossification

Bossche

Maele

Wojtowicz

et al. 2006

Journal Orthopaedic Research

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“…These results were supported by animal studies. 108,109 Studies performed by Izumi 110 and Michelson 108,109 demonstrated that heterotopic bone could be produced in rabbits by forced passive movements in paralytic limbs that had been immobilized for a certain period. It is, therefore, tempting to speculate that (forced) passive movements following a period of immobilization may easily result in shear and tear of soft tissues leading to an increased risk of developing NHO.…”

Section: Risk Factorsmentioning

confidence: 99%

Neurogenic heterotopic ossification in spinal cord injury

2002

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Neurogenic heterotopic ossi®cation (NHO) is a frequent complication in spinal cord injury (SCI) that is often di cult to treat. This review emphasizes the incidence, risk factors and clinical signs of NHO in SCI patients. Although the exact pathophysiology underlying NHO in neurologic patients is not yet understood, di erent pathogenic mechanisms have been proposed in the literature. A selection of the most important theories will be given and discussed. Moreover the di erent diagnostic, therapeutic, and preventive methods currently used in NHO management after SCI will be reviewed.

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“…However, the model is a realistic model of blast injury endured by service members during combat. Although larger animals (ie, rabbit and sheep models) may be better representatives of human HO formation, previous traumatic models using larger animals have had limited success [14,22,26,27]. This model uses a realistic mechanism of injury and reliably induces heterotopic bone without exogenous growth factors.…”

Section: Discussionmentioning

confidence: 99%

Does Blast Medium Affect Heterotopic Ossification in a Blast-amputation Model?

Yoo

Blevins

Gasbarro

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Heterotopic ossification (HO) develops after nearly 2 .3 of traumatic blast amputations in the contemporary battlefield. This phenomenon has potentially devastating consequences for servicemen and women and its pathophysiology warrants further investigation using a previously developed animal blast model. Questions/purposesWe asked, what is the (1) severity (quantity) and (2) type (location) of HO bone formation after a hindlimb blast amputation with two distinct blast media. We hypothesized that a more ''war-relevant'' blast medium could be a more accurate model and potentially intensify the development of HO. Methods Using a Sprague-Dawley rat model, the pathophysiology of ectopic bone formation in a traumatic hindlimb blast amputation was evaluated. Twenty-four animals underwent blast amputations and closure based on a previously established experimental model. Half the amputations were subjected to blasted sand and the other 1/2 to blasted water. Serial orthogonal radiography was performed on each animal until euthanasia at 24 weeks to track the development of HO. Heterotopic bone severity and type were assessed by three independent graders at each time using a novel grading scale to assess quantity and quality of HO. Results All animals had radiographic evidence of HO develop. No differences were observed in ectopic bone development between sand and water blasting regarding severity or type at any time. Animals that received water and sand blasting had moderate HO develop at 24 weeks (median, 2.0 and 2.5 weeks, respectively; range, 1-3 weeks; difference of medians, 0.5; p = 0.67). At the time of euthanasia, 10 animals that were water blasted had Type 3 HO compared with 11 in the sand-blasted group (p = 1.00).The institution of one or more of the authors (DEJ, VDP) has received, during the study period, funding from the United States Department of Defense Congressionally Directed Medical Research Program (Washington, DC, USA). One of the authors certifies that he (VDP), or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of USD 100,000-USD 1,000,000, from the United States Department of Defense Congressionally Directed Medical Research Program (Washington, DC, USA), an amount of USD 100,000-USD 1,000,000 from DePuy Orthopaedics (Warsaw, IN, USA), and USD 100,000-USD 1,000,000 from the Agency for Healthcare Research and Quality (Rockville, MD, USA). Conclusions Our study showed a clear development of HO after hindlimb blast amputation in a Sprague-Dawley rat model; however, no difference was observed in HO development based on the type of blast media. This suggests it is the blast mechanism that induces ectopic bone development, regardless of the blasted medium. The grading scale we developed for our animal-model study provided a reliable means of assessing HO severity and type. Clinical Relevance We anticipate that future investigations will elucidate similarities between service members' wartime extremity injuries and the animal...

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Myositis ossificans following forcible manipulation of the leg. A rabbit model for the study of heterotopic bone formation.

Cited by 100 publications

References 0 publications

Free radical scavengers are more effective than indomethacin in the prevention of experimentally induced heterotopic ossification

Free radical scavengers are more effective than indomethacin in the prevention of experimentally induced heterotopic ossification

Neurogenic heterotopic ossification in spinal cord injury

Does Blast Medium Affect Heterotopic Ossification in a Blast-amputation Model?

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