Post-Traumatic Heterotopic Ossification: An Old Problem in Need of New Solutions

Research output: Contribution to journalReview articlepeer-review

Authors

Colleges, School and Institutes

External organisations

  • Royal Centre for Defence Medicine
  • University Hospital Birmingham

Abstract

Heterotopic ossification (HO) is the formation of pathological bone in ectopic sites and it can have serious consequences for functional outcomes. For many years, its main clinical relevance was as a rare complication of elective joint arthroplasty or CNS injury and a number of prophylaxes were developed to mitigate against it in these settings. As a consequence of changes in patterns of wounding and survival in conflicts since the turn of the century, post-traumatic HO has become much more common and case severity has increased. It represents one of the main barriers to rehabilitation in a large cohort of combat-injured patients. However, extant prophylaxes have not been shown to be effective or appropriate in this patient cohort. In addition, the lack of reliable early detection or means of predicting which patients will develop HO is another barrier to effective prevention. This review examines the current state of understanding of post-traumatic HO including the historical context, epidemiology, pathophysiology, clinical issues, currently prophylaxis and detection, management, and potential future approaches. Our aims are to highlight the current lack of effective means of early detection and prevention of HO after major trauma and to stimulate research into novel solutions to this challenging problem.

Details

Original languageEnglish
Pages (from-to)1061-1068
Number of pages8
JournalJournal of Orthopaedic Research
Volume36
Issue number4
Early online date29 Nov 2017
Publication statusPublished - 23 Apr 2018

Keywords

  • blast injury, combat trauma, Heterotopic ossification, mineralization, prophylaxis, rehabilitation

ASJC Scopus subject areas