Intra- and Periarticular Heterotopic Ossification in the Knee After a Low-Velocity Gunshot Wound Treated With Retrograde Intramedullary Nailing of the Femur

Abstract

This is a case of a 32-year-old man who developed intra- and periarticular heterotopic ossification (HO) after sustaining a low-velocity gunshot wound to the femur treated with intramedullary nailing of the fracture using a retrograde technique. The association between HO after a high-velocity gunshot wounds is well established. In addition, there have been two case reports of intra-articular HO after retrograde intramedullary femoral nailing. However, HO in and around the knee after a low-velocity gunshot wound has not been reported and may be more common than initially thought.

Semiextended Intramedullary Nailing of the Tibia Using a Suprapatellar Approach

“…25 We believe that this is because bone debris cannot typically form new bone in synovial fluid. 25 We believe that this is because bone debris cannot typically form new bone in synovial fluid.…”

Incidence and Risk Factors of Heterotopic Ossification in the Knee After Reamed Tibial Nailing

“…[9][10][11] However, it is discussed at a lesser frequency around or inside the knee joint, although most recent reports mention a frequency of 34% to 37% in patients with a knee dislocation 12,13 and 14% to 39% in patients treated with total knee arthroplasty. [14][15][16] While intra-articular and periarticular HO in the knee has been reported after retrograde IMN of femoral shaft fractures, 17,18 antegrade tibial nailing introduces a similar surgical insult to the knee joint, which can be reflected in overall decreased functional outcome and knee pain after surgery. 19 However, the possible role of HO in post-treatment outcome has not been discussed thus far, and to date, no estimated frequency or associated factors have been reported for the occurrence of HO after reamed tibial nailing.…”