Preoperative irradiation for the prevention of heterotopic ossification induces local inflammation in humans

The Immunological Contribution to Heterotopic Ossification Disorders

“…Long bone fracture repair involves massive inflammation to repair the endogenous skeleton and requires both anabolic and catabolic functions of the immune system during the healing process [21, 24]. Perhaps most striking is that the pro-inflammatory factors implicated in skeletal bone loss during chronic inflammation [28] are also identified as predictive of HO development [12, 13, 15], indicating dual consequences of the immune system in bone biology.…”

“…Serum levels of specific interleukin family cytokines IL-6, and IL-10 [13] and effluent levels of IL-6 and IL-13 [15] were significantly increased in blast injury patients with HO compared to patients that did not develop ectopic bone. Patients who developed HO following total hip arthroplasty also exhibited elevated levels of IL-6 in addition to several other interleukin family cytokines [12]. Interferon gamma (IFN-γ) was also elevated in these patients.…”

Pathogenesis and prevention strategies of heterotopic ossification in total hip arthroplasty: a narrative literature review and results of a survey in Germany

“…Low dosage irradiation of the hip and other joints can be applied if NSAIDs are contraindicated or in addition to an oral HO prophylaxis if the patient is at high risk for HO formation (i.e. known HO formation on contralateral side) [4]. If HO formations increase, they can lead to post-operative pain, bony impingement with impaired range of motion, and finally revision surgery [5] [6].…”

Management of multijoint stiffness of bilateral upper limbs secondary to heterotopic ossification: Case report and literature review

“…Unfortunately, predicting or preventing the development of HO is very difficult [12][13]. Pharmacological interventions or local radiation therapy have been recommended as prophylaxis for HO, but the result is uncertain and controversial [11,[14][15][16][17][18][19]. We administered oral indomethacin as a routine after each operation because some studies had reported its role in prophylaxis for HO [20][21].…”