Heterotopic ossification following lumbar total disc replacement
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Heterotopic bone
Heterotopic ossification is a common complication of surgery or trauma.To investigate the efficacy of levothyroxin in inhibition of heterotopic ossification.Heterotopic ossification was induced in 36 rabbits in three identical groups by injecting 2 mL of bone marrow in right thigh. To prevent heterotopic ossification, levothyroxin (20 microg/kg) was administered orally daily for 4 weeks to two groups of adult rabbits: group A (preload)--starting 1 week preceding bone marrow injection; group B--started on day of injection; and group C--control group (no levothyroxin) in a rabbit model. After 5 weeks the rabbits were evaluated by radiographs for evidence of ossification. At the end of the study histologic samples were taken from all the thighs.Imaging and histologic studies showed, with statistical significance, almost complete prevention of heterotopic ossification in group A (preload) and a marked decrease in group B, when compared with the controls.Levothyroxin demonstrated efficacy in preventing heterotopic ossification.
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Despite considerable documentation for retinoid-induced hyperostosis, sufficient knowledge regarding its management and histologic features is not available. In a 26-year-old man with etretinate-induced heterotopic bone formation about the hip joint, the use of etidronate disodium was unsuccessful. Surgical excision of the heterotopic bone dramatically improved restricted motion of the hip joint without initiating significant postoperative heterotopic ossification. Ultrastructural study showed abundant myofibroblasts in the fibrous tissue close to the heterotopic bone. Their role in local biologic events should be determined.
Heterotopic bone
Etretinate
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Among 26 children with soft tissue ossification 5 patients with pseudomalignant heterotopic ossification were analysed. All patients underwent surgery and were cured. Authors presentation emphasizes the importance of the performance of sparing operation after ossification maturation as well as local application of steroids, appropriate use of immobilization and accurate rehabilitation.
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Heterotopic ossification is characterized by the formation of normal bone at ectopic soft-tissue locations. Regardless of the etiology of heterotopic ossification, requisite pathogenetic conditions include an inductive signal capable of stimulating morphogenesis, a population of inducible osteoprogenitor cells, and a heterotopic environment conducive to osteogenesis. Two rare heritable and developmental forms of heterotopic ossification, fibrodysplasia ossificans progressiva and progressive osseous heteroplasia, provide valuable clinical and pathogenetic insights into heterotopic ossification in humans. A fundamental understanding of the developmental and molecular pathology of these disorders may lead to more effective strategies for preventing and treating heterotopic ossification in humans.
Fibrodysplasia Ossificans Progressiva
Heterotopic bone
Choristoma
Etiology
Myositis ossificans
Heterotopia
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Heterotopic ossification is the most common complication after THR. The authors present the distribution of frequency of ectopic ossification after cementless THR using Mittelmeier and Parhofer-Mönch prosthesis and it's influence on THR outcome. 151 hip joints were evaluated with a follow-up period of more than 2 years. All procedures were performed by a lateral approach. The ectopic ossification was verified according to the Brooker classification. Clinical evaluation was performed according to the d'Aubigne-Postel method in Charnley's modification. The 3rd degree ectopic ossification was found in 14 hip joint and 4th degree ectopic ossification in 2 hip joints (together 10.6%). The positive correlation between the degree of ossification (3rd and 4th) and the decrease of range of motion of the hip joint along with an increase in pain after THR was found.
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Forty-four patients who had fibrodysplasia ossificans progressiva responded by mail to a questionnaire regarding the age at the onset of heterotopic ossification at fifteen commonly involved anatomical sites. The average age of the patients when they responded to the questionnaire was twenty-seven years (range, three to sixty-nine years). The average age at the onset of ossification was five years (range, birth to twenty-five years). The most common sites of early heterotopic ossification were the neck, spine, and shoulder girdle. Thirty-five (80 per cent) of the patients had had some restrictive heterotopic ossification by the age of seven years. By the age of fifteen years, forty-two (more than 95 per cent) of the patients had severely restricted mobility of the upper limbs. In these patients, heterotopic ossification proceeded in a direction that was axial to appendicular, cranial to caudad, and proximal to distal; this pattern appeared typical for fibrodysplasia ossificans progressiva.
Fibrodysplasia Ossificans Progressiva
Myositis ossificans
Appendicular skeleton
Heterotopic bone
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Heterotopic ossification is the formation of bone tissue at an abnormal site. The ossification of soft tissue outside the skeletal system can occur anywhere and can be found in mucosal tissues. This is the first case report of an osteoma mucosalis affecting the nail bed. We also reviewed the heterotopic ossification and calcification of cutaneous and mucosal sites in the PubMed, Scopus, and Google Scholar databases.
Osteoma
Heterotopic bone
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Heterotopic ossification is defined as the development of mature bone tissue outside normal bone. Osteomyelitis is an infection-related inflammatory disorder of the bones. Although pressure sores accompanied by heterotopic ossification have been reported, there have been no reports of osteomyelitis occurring in proximity to heterotopic ossification. Herein, we report a rare case of osteomyelitis in heterotopic ossification after trochanteric pressure sore reconstruction. We also emphasize the importance of proper diagnosis and surgical approach for this infected heterotopic ossification lesion.
Pressure sores
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Radiographs of 236 patients who underwent total hip replacement (THR) were evaluated for heterotopic bone formation. There was no significant difference in the presence and degree of ossification in patients with and without diffuse idiopathic skeletal hyperostosis (DISH). The authors conclude that DISH is not a significant risk factor in the development of heterotopic bone formation following THR.
Heterotopic bone
Hyperostosis
Bone Formation
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220 consecutive hip resurfacing procedures were reviewed at a minimum of two years follow up to assess the incidence of heterotopic ossification and its effect on function and clinical outcome. We also reviewed the pre-operative diagnosis, gender and previous surgery. The overall percentage of heterotopic ossification was 58.63%. The incidence of Brooker 1 was 37.27%, Brooker 2 was 13.18% and Brooker 3 was 8.18%. Male osteoarthritics had the highest incidence of heterotopic bone formation. Three males underwent excision of heterotopic bone, two for pain and stiffness and one for decreased range of movement. Both antero-posterior and lateral radiographs were reviewed for evidence of heterotopic bone formation. 12.7% had no evidence of heterotopic bone formation on one view but clearly had on the second view. Overall we found no evidence that heterotopic bone formation affected the clinical or functional outcome of the hip resurfacing at a mean of 3 years follow up.
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