Heterotopic ossification (HO) is perhaps the
single most significant obstacle to independence, functional mobility, and
return to duty for combat-injured veterans of Operation Enduring
Freedom and Operation Iraqi Freedom. Recent research into the cause(s)
of HO has been driven by a markedly higher prevalence seen in these
wounded warriors than encountered in previous wars or following
civilian trauma. To that end, research in both civilian and military
laboratories continues to shed light onto the complex mechanisms
behind HO formation, including systemic and wound specific factors,
cell lineage, and neurogenic inflammation. Of particular interest,
non-invasive in vivo testing using Raman spectroscopy
may become a feasible modality for early detection, and a wound-specific model
designed to detect the early gene transcript signatures associated
with HO is being tested. Through a combined effort, the goals of
early detection, risk stratification, and development of novel systemic
and local prophylaxis may soon be attainable.