Preoperative versus postoperative irradiation in the prophylaxis of heterotopic bone formation in rats

Kantorowitz, David A.; Miller, Gary J.; Ferrara, Janet A.; Ibbott, Geoffrey S.; Fisher, Richard D.; Ahrens, Charles R.

doi:10.1016/0360-3016(90)90355-n

Cited by 56 publications

(27 citation statements)

References 25 publications

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“…We found histologic progression of HO to be consistent and to occur predictably through a pathway of endochondral ossification. Much of the current knowledge regarding heterotopic bone growth [16,20,22,25,42,47] has been gleaned from studies of nonphysiologic animal models that have induced heterotopic bone formation through the addition of exogenous agents, such as BMP-2, BMP-4, and bone matrix. Among these studies, conflicting observations have been made regarding the mechanisms of bone formation that are dependent on the particular exogenous agent that is used to induce the ectopic bone.…”

Section: Discussionmentioning

confidence: 99%

Heterotopic Bone Formation About the Hip Undergoes Endochondral Ossification: A Rabbit Model

Tannous¹,

Stall²,

Griffith³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Heterotopic ossification (HO) occurs most commonly after trauma and surgery about the hip and may compromise subsequent function. Currently available animal models describing the cellular progression of HO are based on exogenous osteogenic induction agents and may not reflect the processes following trauma.Questions/purposes We therefore sought to characterize the histologic progression of heterotopic bone formation in an animal model that recapitulates the human condition without the addition of exogenous osteogenic material. Methods We used a rabbit model that included intramedullary instrumentation of the upper femur and ischemic crush injury of the gluteal muscle. Bilateral surgical induction procedures were performed on 30 animals with the intention of inciting the process of HO; no supplemental osteogenic stimulants were used. Three animals were sacrificed at each of 10 predetermined times between 1 day and 26 weeks postoperatively and the progression of tissue maturation was graded histologically using a five-item scale. Results Heterotopic bone reliably formed de novo and consistently followed a pathway of endochondral ossification. Chondroid elements were found in juxtaposition with immature woven bone in all sections that contained mature osseous elements. Conclusions These results establish that HO occurs in an animal model mimicking the human condition following surgical trauma about the hip; it is predictable in its histologic progression and follows a pathway of endochondral bone formation. Clinical Relevance By showing a consistent pathway of endochondral ossification leading to ectopic bone formation, this study provides a basis for understanding the mechanisms by which HO might be mitigated by interventions.

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Section: Discussionmentioning

confidence: 99%

Heterotopic Bone Formation About the Hip Undergoes Endochondral Ossification: A Rabbit Model

Tannous¹,

Stall²,

Griffith³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…A recent report from Childs et al [3] showed no increase in the incidence of HO with an interval of 3 days between surgery and RT. Preoperative radiotherapy was used in an experimental model by Kantorowitz et al [11] and shown to be effective in preventing ectopic ossification. Preoperative trials [7,10,16,18,20,25] were initiated with the aim of testing the clinical efficacy whilst eliminating the drawbacks associated with postoperative administration.…”

Section: Resultsmentioning

confidence: 99%

“…However, there are considerable administrative difficulties associated with giving this treatment so soon before surgery. Although the effects of early irradiation (24 h or more before surgery) are uncertain [11,19], promising results have been reported from a preliminary evaluation of treatment at an intermediate preoperative interval (less than 24 h) [16].…”

Section: Introductionmentioning

confidence: 96%

Preoperative, single-fraction irradiation for prophylaxis of heterotopic ossification after total hip arthroplasty

Lonardi

Gioga

Coeli³

et al. 2001

International Orthopaedics (SICOT)

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We gave a single fraction of 750 cGy preoperatively (within 16 h of surgery) to 143 patients prior to total hip arthroplasty. The patients were evaluated for heterotopic ossification at 1, 3 and 6 months. The preoperative radiation did not affect the surgical procedure. After a median follow-up of 12 (6-24) months we encountered six patients with heterotopic ossifications of Brooker grade I-II. Potential late risks from ionising radiation should be considered when treating younger patients.Résumé Cent quarante trois patients ont reçus avant le remplacement prothétique de la hanche (en moyenne 16 heures avant l'intervention) une radiothérapie par une dose unique de 750 cGy. Les patients ont été évalués pour recherche des ossification hétérotopiques à 1, 3 et 6 mois. L'irradiation préopératoire n'a pas affecté la procédure chirurgicale. Avec une médiane de suivi de 12 (6-24) mois six patients ont présentés des ossifications hétérotopiques de niveau Brooker I-II. Les risques tardifs potentiels des radiations ionisantes doivent être pris en compte lorsque on traite des patients jeunes.

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“…Kantorowitz et al (1990) mentioned the possibility of preoperative irradiation but found no similar results between a l-hour preoperative group and a postoperative group.…”

Section: Preoperative Irradiation For Prophylaxis Of Ectopic Ossificamentioning

confidence: 98%

“…The process of ossification appears within 1 day-1 week after surgery and the triggering factor is still unknown (Kantorowitz et al 1990, Goel and Sharp 1991, Pellegrini et al 1992.…”

Section: Preoperative Irradiation For Prophylaxis Of Ectopic Ossificamentioning

confidence: 99%

Preoperative irradiation for prophylaxis of ectopic ossification after hip arthroplasty: A randomized study in 62 hips

Leeuwen

Deckers

Lange

1998

Acta Orthopaedica Scandinavica

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Preoperative versus postoperative irradiation in the prophylaxis of heterotopic bone formation in rats

Cited by 56 publications

References 25 publications

Heterotopic Bone Formation About the Hip Undergoes Endochondral Ossification: A Rabbit Model

Heterotopic Bone Formation About the Hip Undergoes Endochondral Ossification: A Rabbit Model

Preoperative, single-fraction irradiation for prophylaxis of heterotopic ossification after total hip arthroplasty

Preoperative irradiation for prophylaxis of ectopic ossification after hip arthroplasty: A randomized study in 62 hips

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