Heterotopic Ossification and Pseudoarthrosis in the Shoulder Following Encephalitis

An, Howard S.; Ebraheim, Nabil; Kim, K; Jackson, William T.; Kane, Justin T.

doi:10.1097/00003086-198706000-00040

Cited by 26 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…HO frequently complicates central nervous system disorders such as brain and spinal cord injuries, tumors, and encephalitis. [3][4][5][6][7][8] The use of nonsteroidal anti-inflammatory drugs (NSAID), particularly indomethacin, is generally accepted both for the prevention and treatment of HO following nerve injury and major hip surgery. 9 NSAID inhibit the differentiation of mesenchymal cells into osteogenic cells and suppress the post-traumatic prostaglandin-mediated inflammatory response.…”

Section: Introductionmentioning

confidence: 99%

Free radical scavengers are more effective than indomethacin in the prevention of experimentally induced heterotopic ossification

Bossche

Maele

Wojtowicz

et al. 2006

Journal Orthopaedic Research

View full text Add to dashboard Cite

The pathogenesis of heterotopic ossification is still unclear and the preventive therapies are usually insufficient. The present study was designed to investigate the possible preventive effect of free radical scavengers on the development of experimentally induced heterotopic ossification in a rabbit model and to compare free radical scavengers with indomethacin to determine whether they act synergistically. A standard immobilization-manipulation model was used to induce heterotopical ossification in the hind legs of 40 1-year-old female New Zealand albino rabbits. The animals were divided into four groups and received daily either placebo, a free radical scavenger cocktail [allopurinol and N-acetylcysteine (A/A)], indomethacin or the combination of A/A and indomethacin in a randomized double-blind fashion. Every 4 days an X-ray was taken and the thickness and length of new bone formation was measured at the thigh. A marked statistically significant difference was found between the four groups. In the groups that received A/A, either alone or combined with indomethacin, an inhibition of bone growth, both in thickness and in length was demonstrated. In this experimental model free radical scavengers had a superior inhibitory effect on heterotopic ossification than indomethacin. Free radicals could play an important role in the pathogenesis of heterotopic ossification. ß

show abstract

Section: Introductionmentioning

confidence: 99%

Free radical scavengers are more effective than indomethacin in the prevention of experimentally induced heterotopic ossification

Bossche

Maele

Wojtowicz

et al. 2006

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…Like other neurogenic HO, the mechanism of HO after anti-NMDA receptor encephalitis is not clear. Recent studies reveal that pathogenesis of HO involves three requisite components: including osteogenic precursor cells, inducing agents, and a permissive environment [8]. Risk factors for neurogenic HO including the severity of the neurologic injury, presence of the spastic as compared with flaccid paralysis, multiple injuries at the time of trauma.…”

Section: Discussionmentioning

confidence: 99%

“…Prolonged coma and artificial ventilation are important risk factors. Increased duration of artificial ventilation (extremely common in patients with TBI and SCI) may alter the homeostasis of the patients, especially in terms of electrolytes and acid-base balance [8]. In anti-NMDA receptor encephalitis cases, a lot of patients require the support of artificial ventilation, which increases the risks of HO.…”

Section: Discussionmentioning

confidence: 99%

Heterotopic ossification following anti-NMDA receptor encephalitis: a case report

Wang

Huang

et al. 2016

BMC Neurol

View full text Add to dashboard Cite

Background: Heterotopic ossification (HO) is defined as the formation of true bone tissue in non-osseous tissues. HO may occur under several conditions such as soft tissue injury, central nervous system injury and many other diseases like arthopathies, and vasculopathies. The underlying mechanisms of HO are not well elucidated. Anti-NMDA receptor encephalitis is a newly recognized autoimmune mediated disease which is predominant in young female patients with ovarian teratomas. Encephalitis complicated with HO has rarely been reported. Case presentation: Here we report a case of anti-NMDA receptor encephalitis with severe muscle ossifications. A 15 years old female patient presented with fever, changed mental status of confusion, rigidity of the arms and legs, and oral-facial dyskinesias. Diagnosis of anti-NMDA receptor encephalitis was confirmed by detection of anti-NMDA receptor antibodies both in serum and CSF. Due to the severity of the disease, 3-weeks' intensive care and mechanical ventilation were administrated for the patient. Image of pelvic CT and MRI of the patient showed dynamic changing process of HO. The muscles showed edema and scattered inflammation at the very beginning, and then gradually formed mature bone tissue. Conclusions: Anti-NMDA receptor encephalitis often presents with severe neurologic symptoms and requires long time intensive care and mechanical ventilation, which makes the patient easily complicate with HO. More studies are required to elucidate the mechanisms of HO and more attention should be paid to patients with encephalitis who might develop severe muscle ossifications requiring early interventions.

show abstract

“…Travmatik beyin yaralanmas› (TBY), medulla spinalis yaralan-mas› (MSY), inme, poliomyelit, myelodisplazi, karbon monoksit zehirlenmesi, medulla spinalis tümörleri, tabes dorsalis, siringomyeli, tetanoz, multiple skleroz, ensefalit, uzun süren koma, yan›k ve ortopedik cerrahi sonras› HO geliflti¤i bildirilmifltir (8,9,10). fiiddetli TBY'l› hastalar›n %11-76's›nda HO görülür.…”

Section: Tartifimaunclassified

Heterotopic ossification in the myasthenia gravis: A case report

Balcı

Samancı

Oğuz

2005

BMR

View full text Add to dashboard Cite

Heterotopik ossifikasyon, eklem çevresinde yeni kemik oluflumudur. Klinik önemi, potansiyel eklem hareket aral›¤› kayb› olmas›d›r. Genellikle kafa travmas›, medulla spinalis yaralanmas›, yan›k veya direkt kas dokusu travmas› olan hastalarda görülür. Bu çal›flmada kalça eklemlerinin hareket aral›¤›nda k›s›tl›l›k geliflen Myastenia Gravis'li 39 yafl›nda bir hasta sunuldu. Radyografi ve bilgisayarl› tomografide bilateral kalça eklemi etraf›nda yeni kemik oldu¤u gösterildi. Literatürde Myastenia Gravis'de heterotopik ossifikasyon saptanan ilk vakad›r. Muhtemelen kas paralizisinden dolay› uzun süreli total immobilizasyon hastada heterotopik ossifikasyon geliflmesinin nedeni olabilir.

show abstract

Heterotopic Ossification and Pseudoarthrosis in the Shoulder Following Encephalitis

Cited by 26 publications

References 0 publications

Free radical scavengers are more effective than indomethacin in the prevention of experimentally induced heterotopic ossification

Free radical scavengers are more effective than indomethacin in the prevention of experimentally induced heterotopic ossification

Heterotopic ossification following anti-NMDA receptor encephalitis: a case report

Heterotopic ossification in the myasthenia gravis: A case report

Contact Info

Product

Resources

About