To Study the Incidence of Heterotopic Ossification After Anterior Cruciate Ligament Reconstruction

Bhandary, Bhaskara

doi:10.7860/jcdr/2013/5348.2970

Cited by 9 publications

(9 citation statements)

References 14 publications

(16 reference statements)

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“…After HO excision and a 3-month course of postoperative indomethacin, no recurrence was found at minimum 6-month follow-up. A similar series was published by Bhandary et al 12 in 6 patients, although management was not described. Two studies described HO after multiligamentous knee reconstruction.…”

Section: Resultsmentioning

confidence: 67%

Heterotopic Ossification After Arthroscopic Procedures: A Scoping Review of the Literature

Zhou

Gee

Hansen

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Heterotopic ossification (HO) is the formation of bone in soft tissue resultant from inflammatory processes. Lesion formation after arthroscopic procedures is an uncommon but challenging complication. Optimal prophylaxis and management strategies have not been clearly defined. Purpose: To present a scoping review of the pathophysiology, risk factors, diagnostic modalities, prophylaxis recommendations, and current treatment practices concerning HO after arthroscopic management of orthopaedic injuries. Study Design: Scoping review; Level of evidence, 4. Methods: A scoping review via a PubMed search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. The search strategy was based on the terms “heterotopic ossification” AND “arthroscopy.” The clinical outcomes review included studies on the arthroscopic management of orthopaedic injuries in which the primary subject matter or a secondary outcome was the development of HO. An analysis of the pathophysiology, diagnostic modalities, and management options was reported. Results: A total of 43 studies (33,065 patients) reported on HO after hip arthroscopy, while 21 (83 patients) collectively reported on HO after arthroscopic procedures to the shoulder, elbow, knee, or ankle; however, management techniques were not standardized. Identified risk factors for HO included male sex and mixed impingement pathology, while intraoperative capsular management was not suggested as a contributing factor. Diagnosis of ossification foci was performed using radiography and computed tomography. The rate of HO after hip arthroscopy procedures approached 46% without prophylaxis, and administration of nonsteroidal anti-inflammatory drugs (NSAIDs) decreased occurrence rates to 4% but carries associated risks. External beam radiation has not been exclusively studied for use after arthroscopic procedures. Conclusion: HO is a known complication after arthroscopic management of orthopaedic injuries. NSAID prophylaxis has been demonstrated to be effective after hip arthroscopy procedures. Patients with persistent symptoms and mature lesions may be indicated for surgical excision, although variability is present in patient-reported outcome scores postoperatively.

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Section: Resultsmentioning

confidence: 67%

Heterotopic Ossification After Arthroscopic Procedures: A Scoping Review of the Literature

Zhou

Gee

Hansen

et al. 2022

Orthopaedic Journal of Sports Medicine

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“…X-ray of a patient showing heterotrophic calcification and patellar tendon ossification is shown in Figure 2. The incidence of heterotopic calcification reported in the literature was 1.54%–2.58% and inadvertently scattered bone debris in the operative field was described as the most important cause for it 42. Patellar tendon ossification after ACL reconstruction is an extremely rare complication, and till now only three cases have been reported in literature 434445…”

Section: Discussionmentioning

confidence: 99%

No Difference in Outcome of Anterior Cruciate Ligament Reconstruction with “Bone–patellar Tendon-bone versus Semitendinosus-gracilis Graft with Preserved Insertion:” A Randomized Clinical Trial

Gupta

Kapoor

Soni

et al. 2019

IJOO

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Background:The type of graft for anterior cruciate ligament (ACL) reconstruction is still a topic of debate and there is still no clear consensus on the ideal graft for ACL reconstruction.Purpose:This study was conducted to compare the outcome of ACL reconstruction surgery between hamstring tendon graft and bone–patellar tendon-bone (BPTB) graft.Materials and Methods:One hundred and sixty professional athletes were enrolled in the study. They were divided into two groups by computerized randomization. In Group I, ACL reconstruction was done using BPTB graft, and in Group II, ACL reconstruction was done using semitendinosus gracilis graft with preserved tibial insertion (STGPI). Postoperatively, patients were assessed for knee stability, Lysholm score, and WOMAC score.Results:Mean KT-1000 side-to-side difference at 1 year was 2.31 ± 1.68 mm in BPTB cohort and 2.52 ± 1.6 mm in STGPI cohort (P = 0.4); and at 2 years, it was 1.98 ± 1.62 mm in BPTB cohort and 2.23 ± 1.6 mm in STGPI cohort (P = 0.4). Mean Lysholm score at 2 years was 96.1 ± 5.81 in STGPI cohort and 97.3 ± 4.62 in BPTB cohort (P = 0.15). Mean WOMAC score at 2 years was 3.3 ± 2.76 in STGPI cohort and 2.84 ± 2.21 in BPTB cohort (P = 0.25). Graft rupture rate was 3.75%; 3 patients in each group had graft rupture. Kneeling pain was present in 15% (12/80) of patients with BPTB graft whereas none of the patients in STGPI cohort had kneeling pain.Conclusion:There was no difference between two grafts in term of knee stability, visual analog scale score and functional outcome. However, hamstring tendon graft is associated with less donor site morbidity.

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“…The incidence of heterotrophic ossification after ACL reconstruction with BPTB graft vary from 1.54%-2.58%. 21 Mohamed A et al 22 observed that incidence of bone debris after ACL reconstruction surgery was 15% if thorough debridement was done and 65% if no specific debridement protocol was followed. 22 Treatment of patellar tendon ossification is still not well established.…”

Section: Discussionmentioning

confidence: 99%

Remnant bone debris after ACL reconstruction surgery: a cause of heterotrophic calcification and patellar tendon ossification

Kapoor¹

2018

MOJSM

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To Study the Incidence of Heterotopic Ossification After Anterior Cruciate Ligament Reconstruction

Cited by 9 publications

References 14 publications

Heterotopic Ossification After Arthroscopic Procedures: A Scoping Review of the Literature

Heterotopic Ossification After Arthroscopic Procedures: A Scoping Review of the Literature

No Difference in Outcome of Anterior Cruciate Ligament Reconstruction with “Bone–patellar Tendon-bone versus Semitendinosus-gracilis Graft with Preserved Insertion:” A Randomized Clinical Trial

Remnant bone debris after ACL reconstruction surgery: a cause of heterotrophic calcification and patellar tendon ossification

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