Incidence of Heterotopic Ossification in Direct Anterior Total Hip Arthroplasty: A Retrospective Radiographic Review

Tippets, Duane M.; Zaryanov, Anton V.; Burke, W. Vincent; Patel, Preetesh D.; Suárez, Juan C.; Ely, Erin E.; Figueroa, Nathania M.

doi:10.1016/j.arth.2014.04.027

Cited by 51 publications

(54 citation statements)

References 21 publications

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“…Up to one-third of all patients undergoing hip arthroplasty or who have had a severe long bone fracture develop heterotopic ossification that may result in pain, swelling, and a restricted range of motion (Tippets et al, 2014). In myositis ossificans progressiva (also known as fibrodysplasia ossificans progressiva), an extremely rare inherited condition, ossification in muscle and connective tissues occurs spontaneously or following injury (Ramirez et al, 2014).…”

Section: Role In Muscle Injury and Diseasementioning

confidence: 99%

Skeletal and cardiac muscle pericytes: Functions and therapeutic potential

Murray

Baily

Chen

et al. 2017

Pharmacology & Therapeutics

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Pericytes are periendothelial mesenchymal cells residing within the microvasculature. Skeletal muscle and cardiac pericytes are now recognized to fulfill an increasing number of functions in normal tissue homeostasis, including contributing to microvascular function by maintaining vessel stability and regulating capillary flow. In the setting of muscle injury, pericytes contribute to a regenerative microenvironment through release of trophic factors and by modulating local immune responses. In skeletal muscle, pericytes also directly enhance tissue healing by differentiating into myofibers. Conversely, pericytes have also been implicated in the development of disease states, including fibrosis, heterotopic ossication and calcification, atherosclerosis, and tumor angiogenesis. Despite increased recognition of pericyte heterogeneity, it is not yet clear whether specific subsets of pericytes are responsible for individual functions in skeletal and cardiac muscle homeostasis and disease.

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Section: Role In Muscle Injury and Diseasementioning

confidence: 99%

Skeletal and cardiac muscle pericytes: Functions and therapeutic potential

Murray

Baily

Chen

et al. 2017

Pharmacology & Therapeutics

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“…The entity commonly produces deformity of soft tissues, difficulty with the use of prosthetics, joint ankylosis, skin ulceration and/or nerve entrapment (1,2). HO occurs in the setting of familial conditions, such as fibrodysplasia ossificans progressive (FOP), or as a complication of surgery, such as hip arthroplasty (3,4). However, HO is more common in military casualties, presumably due to the unique trauma resulting from blasts and high-velocity projectiles.…”

Section: Introductionmentioning

confidence: 98%

Pilot study for detection of early changes in tissue associated with heterotopic ossification: moving toward clinical use of Raman spectroscopy

Harris

Cilwa

Elster

et al. 2015

Connective Tissue Research

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Over 60% of combat-wounded patients develop heterotopic ossification (HO). Nearly 33% of them require surgical excision for symptomatic lesions, a procedure that is both fraught with complications and can delay or regress functional rehabilitation. Relative medical contraindications limit widespread use of conventional means of primary prophylaxis, such as nonspecific nonsteroidal anti-inflammatory medications and radiotherapy. Better methods for risk stratification are needed to both mitigate the risk of current means of primary prophylaxis as well as to evaluate novel preventive strategies currently in development. We asked whether Raman spectral changes, measured ex vivo, could be associated with histologic evidence of the earliest signs of HO formation and substance P (SP) expression in tissue biopsies from the wounds of combat casualties. In this pilot study, we compared normal muscle tissue, injured muscle tissue, very early HO lesions (< 16 d post-injury), early HO lesions (> 16 d post-injury) and mature HO lesions. The Raman spectra of these tissues demonstrate clear differences in the Amide I and III spectral regions of HO lesions compared to normal tissue, denoted by changes in the Amide I band center (p < 0.01) and the 1340/1270 cm(-1) (p < 0.05) band area and band height ratios. SP expression in the HO lesions appears to peak between 16 and 30 d post-injury, as determined by SP immunohistochemistry of corresponding tissue sections, potentially indicating optimal timing for administration of therapeutics. Raman spectroscopy may therefore prove a useful, non-invasive and early diagnostic modality to detect HO formation before it becomes evident either clinically or radiographically.

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“…Heterotopic ossification (HO) is a frequent complication of musculoskeletal trauma after joint arthroplasty, hip and elbow fractures, and amputation [9,11,24,31]. Because traumatic brain injury is an additional risk factor for HO [7,14], high-energy wartime extremity injuries place warwounded patients at an increased risk of developing debilitating heterotopic lesions [10].…”

Section: Introductionmentioning

confidence: 99%

Botulinum Toxin-induced Muscle Paralysis Inhibits Heterotopic Bone Formation

Ausk

Gross

Bain

2015

Clinical Orthopaedics &Amp; Related Research

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Background Short-term muscle atrophy induced by botulinum toxin A (BTxA) has been observed to impair osteogenesis in a rat closed femur fracture model. However, it is unclear whether the underlying mechanism is a direct effect of BTxA on muscle-bone interactions or an indirect effect that is driven by skeletal unloading. Because skeletal trauma in the closed fracture model also leads to disuse atrophy, we sought to mitigate this confounding variable by examining BTxA effects on muscle-bone interactions in two complementary in vivo models in which osteogenesis is induced in the absence of skeletal unloading. The overall aim of this study was to identify a potential strategy to inhibit pathological bone formation and heterotopic ossification (HO). Questions/purposes (1) Does muscle paralysis inhibit periosteal osteogenesis induced by a transcortical defect? (2) Does muscle paralysis inhibit heterotopic bone formation stimulated by intramuscular bone morphogenetic protein (BMP) injection? Methods Focal osteogenesis was induced in the right hindlimb of mice through surgical initiation of a small transcortical defect in the tibia (fracture callus; n = 7/group) or intramuscular injection of BMP-2 (HO lesion; n = 6/group), both in the presence/absence of adjacent calf paralysis. High-resolution micro-CT images were obtained in all experimental groups 21 days postinduction and total volume (ie, perimeter of periosteal callus or HO lesion) and bone volume (calcified tissue within the total volume) were quantified as primary outcome measures. Finally, these outcome measures were compared to determine the effect of muscle paralysis on inhibition of local osteogenesis in both studies.Results After a transcortical defect, BTxA-treated mice showed profound inhibition of osteogenesis in the periosteal fracture callus 21 days postsurgery compared with saline-treated mice (total volume: 0.08 ± 0.06 versus 0.42 ± 0.11 mm 3 , p \ 0.001; bone volume: 0.07 ± 0.05 versus 0.32 ± 0.07 mm 3 , p \ 0.001). Similarly, BMP-2-induced HO formation was inhibited by adjacent muscle paralysis at the same time point (total volume: 1.42 ± 0.31 versus 3.42 ± 2.11 mm 3 , p = 0.034; bone volume: 0.68 ± 0.18 versus 1.36 ± 0.79 mm 3 , p = 0.045). Conclusions Our data indicate that BTxA-induced neuromuscular inhibition mitigated osteogenesis associated with both a transcortical defect and BMP-2-induced HO. Clinical Relevance Focal neuromuscular inhibition represents a promising new approach that may lead to a new clinical intervention to mitigate trauma-induced HO, a healthcare challenge that is severely debilitating for civilian and war-wounded populations, is costly to both the patient and the healthcare system, and currently lacks effective treatments.

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Incidence of Heterotopic Ossification in Direct Anterior Total Hip Arthroplasty: A Retrospective Radiographic Review

Cited by 51 publications

References 21 publications

Skeletal and cardiac muscle pericytes: Functions and therapeutic potential

Skeletal and cardiac muscle pericytes: Functions and therapeutic potential

Pilot study for detection of early changes in tissue associated with heterotopic ossification: moving toward clinical use of Raman spectroscopy

Botulinum Toxin-induced Muscle Paralysis Inhibits Heterotopic Bone Formation

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