Heterotopic ossification of the shoulder after central nervous system lesion: indications for surgery and results

Pansard, E.; Schnitzler, A.; Lautridou, C.; Judet, T.; Denormandie, P.; Genêt, F.

doi:10.1016/j.jse.2012.08.017

Cited by 16 publications

(16 citation statements)

References 31 publications

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“…These studies highlight the potential sequelae of non-operative management which include osteopenia, ankylosis and ligament contractures. This must be balanced with operative risk which includes recurrence of HO and neurovascular damage 6. Timing of intervention is another controversial topic within the field, with conflicting evidence to support both early and delayed resection 12…”

Section: Discussionmentioning

confidence: 99%

Heterotopic ossification following anterior shoulder dislocation

Patel¹,

Brkljac

Sonar

et al. 2018

BMJ Case Reports

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Heterotopic ossification (HO) is the abnormal growth of extraskeletal bone. Joint involvement may result in chronic stiffness and pain causing considerable functional impairment and the inability to perform the activities of daily living. HO affecting the shoulder joint is rare and little is known about its clinical course or treatment. Here, we describe the first reported case of glenohumeral HO following anterior dislocation. This occurred in a 70-year-old man following a fall onto outstretched hand. Due to persistent stiffness and pain at 8 months from initial injury, he underwent plain radiographs and MRI scans that confirmed rotator cuff tear and HO. He was managed conservatively with physiotherapy and non-steroidal anti-inflammatory drugs. At 1-year follow-up, the patient maintains a good functional outcome.

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Section: Discussionmentioning

confidence: 99%

Heterotopic ossification following anterior shoulder dislocation

Patel¹,

Brkljac

Sonar

et al. 2018

BMJ Case Reports

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“…In TBI- and SCI-patients, two-thirds of the HOs develop in the hip, followed by formation of HOs around the knee and elbow joint. HOs of the shoulder joint after CNS-lesions are less frequently seen with an incidence described by Pansard et al 5) of 3.5%.…”

Section: Discussionmentioning

confidence: 91%

“…And overall, less recurrence of HOs is seen in patients with good neurological recovery and motor function. 5 8) …”

Section: Discussionmentioning

confidence: 99%

Bilateral Scapulohumeral Ankylosis after Prolonged Mechanical Ventilation

et al. 2016

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This case demonstrates a rarely reported bilateral scapulohumeral bony ankylosis. A young woman developed extensive heterotopic ossifications (HOs) in both shoulder joints after being mechanically ventilated for several months at the intensive care unit in a comatose status. She presented with a severe movement restriction of both shoulder joints. Surgical resection of the bony bridges was performed in 2 separate sessions with a significant improvement of shoulder function afterwards. No postoperative complications, pain, or recurrence of HOs were noted at 1-year follow-up. Mechanical ventilation, immobilization, neuromuscular blockage, and prolonged sedation are known risk factors for the development of HOs in the shoulder joints. Relatively early surgical resection of the HOs can be performed safely in contrary to earlier belief. Afterwards, nonsteroidal anti-inflammatory drugs and/or radiation therapy can be possible treatment modalities to prevent recurrence of HOs.

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“…One patient had humeral head osteonecrosis requiring hemiarthroplasty, and one had distal clavicular instability managed nonoperatively. Pansard et al also published their experience this year with sixteen brain-injured patients (nineteen shoulders) with heterotopic ossification about the shoulder 50 . They reported gains in forward elevation by 69°, abduction by 60°, and external rotation by 13°.…”

Section: Heterotopic Ossificationmentioning

confidence: 99%