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

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Post-Traumatic Heterotopic Ossification : An Old Problem in Need of New Solutions. / Eisenstein, Neil; Stapley, Sarah; Grover, Liam.

In: Journal of Orthopaedic Research, Vol. 36, No. 4, 23.04.2018, p. 1061-1068.

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@article{187b6846c3e14671aebd7e6499d3829a,
title = "Post-Traumatic Heterotopic Ossification: An Old Problem in Need of New Solutions",
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.",
keywords = "blast injury, combat trauma, Heterotopic ossification, mineralization, prophylaxis, rehabilitation",
author = "Neil Eisenstein and Sarah Stapley and Liam Grover",
year = "2018",
month = apr,
day = "23",
doi = "10.1002/jor.23808",
language = "English",
volume = "36",
pages = "1061--1068",
journal = "Journal of Orthopaedic Research",
issn = "0736-0266",
publisher = "Wiley",
number = "4",

}

RIS

TY - JOUR

T1 - Post-Traumatic Heterotopic Ossification

T2 - An Old Problem in Need of New Solutions

AU - Eisenstein, Neil

AU - Stapley, Sarah

AU - Grover, Liam

PY - 2018/4/23

Y1 - 2018/4/23

N2 - 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.

AB - 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.

KW - blast injury

KW - combat trauma

KW - Heterotopic ossification

KW - mineralization

KW - prophylaxis

KW - rehabilitation

UR - http://www.scopus.com/inward/record.url?scp=85045848210&partnerID=8YFLogxK

U2 - 10.1002/jor.23808

DO - 10.1002/jor.23808

M3 - Review article

C2 - 29193256

AN - SCOPUS:85045848210

VL - 36

SP - 1061

EP - 1068

JO - Journal of Orthopaedic Research

JF - Journal of Orthopaedic Research

SN - 0736-0266

IS - 4

ER -