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At least 1,369 records · Page 76Linked to original sources
PubMed1999

Functional outcome of excision of heterotopic ossification after total hip arthroplasty.

Fifty-three cases of symptomatic heterotopic ossification were evaluated after total hip arthroplasty for the specific purpose of determining the value of surgical excision without revision or other concurrent procedures. The mean followup was 3.5 years for range of motion and 7.8 years for radiographic evaluation. A statistically significant increase in range of motion was obtained for the group at final followup. The mean increase in flexion arc was 34 degrees, abduction and adduction arc was 22 degrees, and rotation arc was 21 degrees. Of the patients who underwent surgical excision of heterotopic bone solely because of pain, none had complete alleviation of symptoms. It is concluded that surgical excision of heterotopic bone results in significant improvement in functional outcome, but it cannot be expected to predictably alleviate pain. Finally, the ultimate arc of motion was better than that suggested radiographically by the Brooker classification system.

Adult↗
PubMedDate not supplied

MRI of ossification of ligamentum flavum.

Magnetic resonance imaging of 28 patients with radiological and/or histopathologically proved ossification of the ligamentum flavum (OLF) was reviewed. The locations of OLF were cervical (n = 4), thoracic (n = 22), and lumbar (n = 2). On T1- and T2-weighted images, OLF demonstrated low signal intensity. Areas of high or intermediate signal intensity within the OLF on T1-weighted images were observed in three cases and were interpreted to be due to fat infiltration. In six cases, high intensity areas in the spinal cord caused by compressing OLF were demonstrated on T2-weighted images. Gadolinium-diethylenetriamine pentaacetic acid, which was used in four cases, showed cord enhancement at the level of compression by OLF in three cases.

Aged↗
PubMed1991

Open reduction and internal fixation of acetabular fractures: heterotopic ossification and other complications of treatment.

Open reduction and internal fixation was performed on 50 displaced acetabular fractures in 49 patients by nine different attending surgeons over a 10-year period. At an average follow-up of 38 months, poor results were noted clinically in 38% and radiographically in 40%. The incidence of short- and long-term complications was greater than in other studies. Particularly distressing was the 58% incidence of heterotopic ossification (HO). Twenty-four percent had grade III or IV; five hips were autofused and the remainder had 40-60% loss of motion. There was no correlation of HO with age, sex, fracture type, degree of comminution, associated femoral head fracture or dislocation, delay to surgery, or operative time. However, 26 of 28 patients who had a trochanteric osteotomy as part of the operative exposure developed HO. Other complications included wound infection (12%), avascular necrosis of the femoral head (10%), nerve palsy (8%), and deep vein thrombosis/pulmonary embolism (8%). The data suggest formulation of specific treatment protocols, an awareness of surgical risks, and that staff specialization may reduce complications and improve outcome. Avoiding a trochanteric osteotomy at surgery and using prophylactic postoperative irradiation or indomethacin are suggested to reduce HO.

Acetabulum↗
PubMed1993

Heterotopic ossification after femoral intramedullary rodding.

Heterotopic ossification (HO) after femoral intramedullary rodding is a significant complication of the procedure. One hundred eighteen cases of femoral roddings performed on 113 patients were available for review. The data were computerized and evaluated using univariate analysis and multivariate regression analysis. A statistically significant increase of HO was found with male gender, increased delay to surgery, and in patients requiring prolonged intubation because of their multiple injuries. HO was classified using a modified version of the method of Brumback et al. (grades 0-IV). A strong correlation of HO with brain injury documented by computed tomography scan was also found to be statistically significant for the more severe grades of HO. This group of patients had not previously been identified as being at high risk for HO.

Adolescent↗
PubMed1996

Articulated radial head replacement and elbow release for post head-injury heterotopic ossification.

This is a case report of the release of an elbow ankylosed by post-head-injury heterotopic ossification. An extensive bony resection and soft-tissue release was required. At surgery a pathological, osteoporotic fracture of the radial head was found that could not be preserved and thus was removed. In its place an articulated "floating radial head prosthesis" was used that allowed immediate rehabilitation and avoided the need for temporary joint distraction or stabilization. The initial excellent function achieved has been maintained, at a > 3-year follow-up and without the complications experienced with silicone radial head prostheses.

Adult↗
PubMed1996

Three-view radiographic assessment of heterotopic ossification after acetabular fracture surgery.

A random sample of 100 patients who had operative treatment for a fracture of the acetabulum, an otherwise normal appearing hip joint, and at least one year of follow-up were analyzed to assess heterotopic ossification (HO) and its relationship to hip motion. The extent of HO was graded in a blinded fashion according to the Brooker classification, which relies solely on the anteroposterior (AP) view, as well as a modified classification using three radiographic views (AP pelvis, internal, and external Judet oblique views). For each patient, range of motion of the affected hip was compared with that of the contralateral normal limb. There were 16 cases with disagreement between the two methods. As opposed to the Brooker method, the modified classification provided an accurate correlation with the actual hip range of motion.

Acetabulum↗
PubMed2001

Limitation of flexor tendon excursion by heterotopic ossification after isolated flexor tendon laceration.

A patient, one year after flexor digitorum superficialis/profundus repair in the left index finger, was diagnosed with heterotopic ossification involving the palmar surface of the proximal phalanx creating a secondary proximal interphalangeal joint contracture. A Compass PIP Hinge facilitated the treatment. Flexor tendon excursion improved, and active range of motion increased from 60 to 90 degrees before surgery to 30 to 105 degrees 20 months after surgery. Ectopic bone involvement of the hand is rare. This article reports a successful treatment for a unique complication of flexor injury and repair.

Accidents, Occupational↗
PubMed2003

Heterotopic ossification after knee dislocation: the predictive value of the injury severity score.

OBJECTIVE: To determine the relationship of multiple variables, including the Injury Severity Score (ISS), closed head injury (CHI), and timing and type of surgery to formation of motion-limiting heterotopic ossification (HO) following knee dislocation. DESIGN: Longitudinal observational study. SETTING: University level 1 trauma center. PATIENTS/PARTICIPANTS: Thirty-five consecutive patients with 36 knee dislocations (OTA fracture and dislocation classification 40-D) admitted over a 26-month period. MAIN OUTCOME MEASUREMENTS: Admission ISS, Glasgow Coma scale (GCS) scores, CHI, timing (> or < 3 weeks from injury) and type (open or arthroscopic) of surgery, number of cruciate ligaments reconstructed, medial surgical procedure, and eventual presence or absence of motion-limiting HO. RESULTS: A classification system for HO was developed ranging from none (type 0) to ankylosing (type IV) HO. Twenty-nine patients with type 0-III HO recovered an average range of motion of 126 degrees at an average of 14 months (group A). Six patients formed ankylosing type IV HO (group B). The ISS in group A ranged from 9 to 26. ISS in group B ranged from 26 to 50 (P < 0.001). Regarding the formation of type IV HO, the sensitivity of an ISS >/=26 was 100%, the specificity was 97%, and the positive predictive value was 86%. Patients in group B had a greater incidence of documented CHI (P < 0.025). Timing and type of surgery, number of ligaments reconstructed, and whether or not the patient had a medial surgical procedure had no statistical influence on degree of HO formation. CONCLUSIONS: An ISS of 26 seems to be a discrete boundary above which patients with knee dislocation are at extremely high risk for type IV HO formation if undergoing surgical reconstruction and below which patients are likely spared this complication. The presence of a CHI is a significant factor in type IV HO formation, although harder to quantify. None of the remaining independent variables studied were significantly related to ankylosing type IV HO formation.

Anterior Cruciate Ligament Injuries↗
PubMed2004

Excision of heterotopic ossification of the popliteal space following traumatic brain injury.

The occurrence of heterotopic ossification (HO) in traumatic brain injury (TBI) patients has been well described. A 20-year-old male with a fixed knee flexion contracture of 45 degree underwent side excision of heterotopic bone from the popliteal region 17 weeks following a TBI. This case is presented not only for being unique in the location of HO requiring excision but also to emphasize the importance of the awareness of the potential for HO formation in the TBI patient.

Adult↗
PubMed2004

Heterotopic ossification of the quadriceps following distal femoral traction: a report of three cases and a review of the literature.

SUMMARY: We present the previously unreported complication of symptomatic heterotopic ossification of the quadriceps following placement of a large-diameter Steinmann pin for the purpose of temporary skeletal traction. Following the development of distal quadriceps heterotopic bone formation in three patients, we conducted a comprehensive search of the literature using the Medline database from 1966 to the present. A variety of publications, including review articles, case reports, and randomized prospective studies, were used for the literature review. This potential complication should be considered when using a large-diameter Steinmann pin in the distal femur for skeletal traction.

Adult↗
PubMed1993

Heterotopic ossification of the patellar tendon following intramedullary nailing of the tibia: report on two cases.

Heterotopic ossification (HO) of the patellar tendon following intramedullary nailing of the tibia for fracture, which has not been previously documented, occurred in 2 of 31 patients reviewed who had adequate follow-up after this procedure. One suffered grade IV HO and the other grade II HO using a modification of the Brooker classification. The patient with grade IV HO had serious disability from pain and decreased range of motion. Risk factors previously suggested were associated with the formation of heterotopic bone in our two patients. These factors included head injury and long-term hypoxemia.

Adult↗
PubMed2004

Diffuse pulmonary ossification.

Diffuse pulmonary ossification (DPO) is an uncommon condition that is characterized by metaplastic bone formation in the lung parenchyma. It is usually not diagnosed clinically and may be apparent radiographically only when extensive. However, it is occasionally encountered at autopsy or on pathologic evaluation of surgical specimens. This article will review the clinical, histologic, and radiographic manifestations of DPO, focusing primarily on the chest radiograph and CT findings, both of which may be underappreciated, for even experienced radiologists may confuse DPO with other entities such as metastatic calcification as seen in chronic renal failure or chronic granulomatous disease.

Calcinosis↗
PubMed2001

Slit-ventricle syndrome secondary to shunt-induced suture ossification.

OBJECTIVE: To report five children with slit-ventricle syndrome who were found to have increased intracranial pressure despite functioning cerebrospinal fluid shunts. METHODS: Computed tomographic scans demonstrated erosion of the inner table of the cranium and sclerosis of the cranial sutures, particularly the coronal suture. Magnetic resonance imaging scans demonstrated no cerebrospinal fluid over the convexities. The patients were treated with cranial expansion operations that included removal of the sclerotic sutures, which were examined histologically. RESULTS: Postoperatively, symptoms resolved for all children. Sutures were abnormal and contained foci of cartilage and bone within abnormally arranged fibrous tissue. CONCLUSION: We postulate that chronic overdrainage of cerebrospinal fluid via shunts dampens the normal cerebral pressure waves; growth of the calvarium is thus understimulated, and this leads to ossification of the sutures, which become unable to expand to allow normal brain growth. Shunt-induced craniostenosis should be considered for children with symptoms of slit-ventricle syndrome for whom shunts are functional but intracranial pressure is increased. Cranial expansion operations may be more appropriate treatments than subtemporal decompressions for such children, given the diffuseness of the suture pathological features.

Cerebral Ventricles↗
PubMed1992

Heterotopic ossification and deep venous thrombosis: concurrence (?), bleeding complications, and caval interruption.

Diagnosis and treatment of apparent deep venous thrombosis in a patient with spinal cord injury can be difficult. Heterotopic ossification in the paralyzed limbs of such patients can mimic deep venous thrombosis and can even produce false-positive findings on venograms. Anticoagulation, in turn, can be associated with soft tissue hemorrhage that may resemble thrombophlebitis and further confound interpretation of venograms. We have presented a case in which all these phenomena were present and in which a remaining risk of embolism was successfully managed through placement of a Greenfield filter.

Adult↗
PubMedDate not supplied

Extensive simultaneous multisegment laminectomy for myelopathy due to the ossification of the posterior longitudinal ligament in the cervical region.

Extensive simultaneous multisegment laminectomy (ESML) for treatment of ossification of the posterior longitudinal ligament (OPLL) in the cervical region is a technique which cuts the laminae on the median line and on the pedicles with an air drill, and then, the right and left halves of laminae are lifted simultaneously. This technique provides a protection to the spinal cord that swells instantaneously after decompression. A total of 155 cases were followed up for more than 1 year. According to the Japanese Orthopedic Association's evaluation criteria, 127 cases (81.9%) showed some improvement; specifically, 57 cases (36.8%) were rated excellent; 28 (18.1%), good; 42 (27.1%), fair; 11 (7.1%), unchanged; and 17 (11.0%) had poor results.

Activities of Daily Living↗
PubMed1988

Comparison of the results of laminectomy and open-door laminoplasty for cervical spondylotic myeloradiculopathy and ossification of the posterior longitudinal ligament.

Laminectomy was performed on 14 patients with cervical radiculomyelopathy and ossification of the posterior longitudinal ligament (OPLL). Since 1978, simple open-door laminoplasties have been performed on 75 patients. A retrospective study was done to determine if there was any difference between the results of laminectomy and laminoplasty. Overall results of laminectomy were as follows: The preoperative Japanese Orthopaedic Association (JOA) score was 7.0 points and the postoperative score was 15.0 points. Overall results of laminoplasty were as follows: the preoperative JOA score was 7.0 points and the postoperative score was 15.0 points. The percentage improvement in laminectomy was 81.1%, and in laminoplasty was 81.4%. There was no significant difference in the results of these two procedures for the treatment of patients with cervical radiculomyelopathy and OPLL.

Adult↗
PubMed1993

Increase of serum growth hormone-binding protein in patients with ossification of the posterior longitudinal ligament of the spine.

Serum growth hormone-binding protein (GHBP) was measured in 26 patients with ossification of the posterior longitudinal ligament of the spine (OPLL) and 19 age-matched controls. Serum GHBP level was significantly higher in the OPLL group than in the controls, whereas there was no statistical difference between the two groups in serum level of growth hormone, insulin-like growth factor (IGF)-1, and IGF-2. These results, taken together with the hypothesis that serum GHBP reflects the number of GH receptors in tissue, suggest that GH receptors are increased in patients with OPLL.

Carrier Proteins↗