Heterotopic ossification after total elbow arthroplasty: a systematic review

Liu, Eva Y.; Hildebrand, Alexandra; Horner, Nolan S.; Athwal, George S.; Khan, Moin; Alolabi, Bashar

doi:10.1016/j.jse.2018.10.003

Cited by 16 publications

(8 citation statements)

References 53 publications

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“…We found that the overall prevalence of HO was 14% after primary TKA, which is comparable with the 10% rate reported after a total elbow arthroplasty. 5 This rate is markedly lower compared with other TJAs because previous reviews of total ankle arthroplasty and cervical total disk arthroplasty found that 66% 4 of patients and 44.6% 2 of patients developed postoperative HO, respectively. However, the severity of HO, rather than just its presence, is most clinically relevant, with advanced/severe HO after cervical total disk arthroplasty reported to be 11.1%.…”

Section: Discussionmentioning

confidence: 93%

“…For example, a recent systematic review of HO after total elbow arthroplasty found that 25% of patients who developed HO were symptomatic and, of those, 22% required subsequent revision surgery. 5 …”

Section: Discussionmentioning

confidence: 99%

“… 1 HO is also a widely reported sequela of surgery, specifically total joint arthroplasty (TJA), and previous reports have documented the presence of HO development after a variety of TJA procedures. 2 3 4 5 …”

mentioning

confidence: 99%

“…To this end, previous systematic reviews have collated studies of total elbow, ankle, cervical disk, and hip arthroplasties and reported the overall postoperative rates of HO after these procedures. 2 3 4 5 However, although the total knee arthroplasty (TKA) is a commonly performed procedure, no summative assessment exists in the literature reporting on the postoperative development of HO and its implications after TKA. Thus, the objective of this systematic review and meta-analysis was to perform a comprehensive analysis on the reported prevalence of HO after a TKA.…”

mentioning

confidence: 99%

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Relatively Low Rate of Heterotopic Ossification Following Primary Total Knee Arthroplasty: A Systematic Review and Meta-analysis

et al. 2021

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Background: Heterotopic ossification (HO) is abnormal growth of ectopic bone and negatively affects the outcomes after total knee arthroplasty (TKA). This systematic review and meta-analysis were performed to characterize the prevalence and severity of HO after primary TKA. Methods: A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Patient demographics, publication year, and HO prevalence after a primary TKA were recorded. A meta-analysis was performed to determine the overall prevalence of HO formation, and a subanalysis compared the studies published in different timeframes to determine whether a temporal effect exists for HO prevalence. Results: Two thousand nine hundred eighty-eight patients underwent primary TKA across the included studies. Fourteen percent of patients (9% to 20%; I 2 : 93.68%) developed HO postoperatively during a mean follow-up of 40.1 months (11 to 108 months). HO rates seemed to decrease in studies published in more recent years, with a pooled HO prevalence of 5% (0% to 13%; I 2 : 92.26%) among studies published in the past 15 years compared with 18% (12% to 25%; I 2 : 92.49%) among studies published before then. Conclusion: Although studies reported a relatively low overall rate of HO after a primary TKA, the absence of a single, standardized classification system precludes the comparisons of HO severity between studies. Overall, HO prevalence seems to have decreased over time, likely reflecting the changes in perioperative medication protocols.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Relatively Low Rate of Heterotopic Ossification Following Primary Total Knee Arthroplasty: A Systematic Review and Meta-analysis

et al. 2021

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“…There is a documented incidence of approximately 60% among high-energy blast-injured patients wounded during the recent war efforts in Iraq and Afghanistan [10–13]. Post-traumatic HO is a significant complication and it is often associated with pain, skin breakdown, impaired prosthetic fitting, decreased joint range-of-motion, neurovascular compromise and ultimately a dysfunctional outcome, culminating in a poor quality of life [7, 12, 14, 15].…”

Section: Introductionmentioning

confidence: 99%

In vivo model of human post-traumatic heterotopic ossification demonstrates early fibroproliferative signature

et al. 2019

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Background The relationship between the tissue injury healing response and development of heterotopic ossification (HO) is poorly understood. Here we compare a rat blast model and human traumatized muscle from a blast injury to study the early signatures of osteogenesis and fibrosis during the formation of HO. Methods Rat and human tissues were characterized using histology, scanning electron microscopy, immunohistochemistry, as well as gene and protein expression analysis. Additionally, animals and humans were assessed radiographically for HO formation following injury. Results Markers of bone formation were dramatically increased in tissue samples from both humans and rats, and both displayed increased fibroproliferative regions within the injured tissues and elevated expression of markers of tissue fibrosis such as TGF-β1, Fibronectin, SMAD3 and PAI-1. Markers of inflammation and fibrosis ( ACTA , TNFα , BMP1 and BMP3 ) were elevated at the RNA level in both rat and human samples. By day 42, bone formation in the rat blast model appeared similar in radiographs compared to human patients who progressed to develop post-traumatic HO. Conclusions Our data demonstrates that a similar early fibrotic response is evident in both the rat blast model and the human tissues following a traumatic injury and demonstrates the relevance of this animal model for future translational studies.

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