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heterotopic ossification brain injury

Khawla Achour, Eya Mersni, Bassem Krifa, Emna Bahlouli, Sonia Lebib, Catherine Dziri
OBJECTIVE: The aim of this work is to determine the epidemiological and characteristics and the therapeutic modalities of heterotopic ossification in brain injury. MATERIAL/PATIENTS AND METHODS: Retrospective study conducted between January 2010 and January 2016, including patients hospitalized for management of sequelae of an isolated head injury or associated with multiple trauma, and in whom the diagnosis of of heterotopic ossification (HO) was increased. A review of epidemiological data (including age, sex, occupation, type of neurological injury, discovering circumstances of HO), clinical data, the therapeutic choice and evolutivity...
September 2016: Annals of Physical and Rehabilitation Medicine
Waleed Almangour, Alexis Schnitzler, Marjorie Salga, Charlotte Debaud, Philippe Denormandie, François Genêt
OBJECTIVE: A systematic review of the literature to determine whether in patients with neurological heterotopic ossification (NHO) after traumatic brain injury, the extent of the neurological sequelae, the timing of surgery and the extent of the initial NHO affect the risk of NHO recurrence. DATA SOURCES: We searched MEDLINE via PubMed and Cochrane library for articles published up to June 2015. Results were compared with epidemiological studies using data from the BANKHO database of 357 patients with central nervous system (CNS) lesions who underwent 539 interventions for troublesome HO...
September 2016: Annals of Physical and Rehabilitation Medicine
B M Isaacson, B K Potter, R D Bloebaum, R T Epperson, B S Kawaguchi, T M Swanson, P F Pasquina
BACKGROUND: Heterotopic ossification (HO) is a debilitating condition that occurs following traumatic injury and may restrict range of motion and delay rehabilitation. The timing and efficacy of surgical resection have varied widely, and there is a gap in knowledge between clinical predictors of HO recurrence and histological analysis. METHODS: Thirty-three service members seen at Walter Reed National Military Medical Center for symptomatic HO were enrolled in an institutional review board-approved study...
April 20, 2016: Journal of Bone and Joint Surgery. American Volume
Emre Adiguzel, Ayça Uran, Serdar Kesikburun, Özlem Köroğlu, Yasin Demir, Evren Yaşar
BACKGROUND: Heterotopic ossification (HO) is the ectopic bone formation in non-osseous tissues. This study aimed to present two patients with traumatic brain injury (TBI) who had HO in knee joint and pain relief after genicular nerve blockage. Case 1: A 14-year-old patient with TBI was admitted with bilateral knee pain and limited range of motion. Physical examination and x-ray graphics revealed calcification which was diagnosed as HO. Ultrasonography (US) guided genicular nerve blockage was performed to both knees with 2 ml lidocaine and 1 ml betamethasone...
2015: Brain Injury: [BI]
Kavitha Ranganathan, Shawn Loder, Shailesh Agarwal, Victor W Wong, Victor C Wong, Jonathan Forsberg, Thomas A Davis, Stewart Wang, Aaron W James, Benjamin Levi
➤ Heterotopic ossification occurs most commonly after joint arthroplasty, spinal cord injury, traumatic brain injury, blast trauma, elbow and acetabular fractures, and thermal injury.➤ The conversion of progenitor cells to osteogenic precursor cells as a result of cell-mediated interactions with the local tissue environment is affected by oxygen tension, pH, availability of micronutrients, and mechanical stimuli, and leads to heterotopic ossification.➤ Radiation and certain nonsteroidal anti-inflammatory medications are important methods of prophylaxis against heterotopic ossification...
July 1, 2015: Journal of Bone and Joint Surgery. American Volume
M Arduini, F Mancini, P Farsetti, A Piperno, E Ippolito
In this paper we propose a new classification of neurogenic peri-articular heterotopic ossification (HO) of the hip based on three-dimensional (3D) CT, with the aim of improving pre-operative planning for its excision. A total of 55 patients (73 hips) with clinically significant HO after either traumatic brain or spinal cord injury were assessed by 3D-CT scanning, and the results compared with the intra-operative findings. At operation, the gross pathological anatomy of the HO as identified by 3D-CT imaging was confirmed as affecting the peri-articular hip muscles to a greater or lesser extent...
July 2015: Bone & Joint Journal
Dominik Baschera, Hooman Rad, Dermot Collopy, René Zellweger
OBJECTIVE: The aim of the study was to evaluate predictors and clinical relevance of heterotopic ossification (HO) in patients treated for acetabular fractures in a tertiary referral centre. PATIENTS AND METHODS: The study is a retrospective cohort study with a nested case-control study. All patients treated with internal fixation of acetabular fractures from January 2004 to October 2013. Ninety patients had postoperative imaging available at 6 and 12 months postoperatively and received no prophylaxis...
2015: Journal of Orthopaedic Surgery and Research
ZaWaunyka W Lazard, Elizabeth A Olmsted-Davis, Elizabeth A Salisbury, Zbigniew Gugala, Corrine Sonnet, Eleanor L Davis, Eric Beal, Eroboghene E Ubogu, Alan R Davis
BACKGROUND: Heterotopic ossification (HO) is the process of bone formation at a nonskeletal site. Recently, we showed that the earliest steps occur in sensory nerves. We now extend these studies by identifying unique osteogenic progenitors within the endoneurial compartment of sensory nerves. QUESTIONS/PURPOSES: We asked: (1) What is the nature of the osteoprogenitor in the endoneurium of peripheral nerves? (2) How do osteoprogenitors travel from the nerve to the site of new bone formation? METHODS: HO was induced by intramuscular injection of Ad5BMP-2-transduced cells in mice...
September 2015: Clinical Orthopaedics and related Research
Alison K Godbolt, Maud Stenberg, Jan Jakobsson, Kimmo Sorjonen, Karolina Krakau, Britt-Marie Stålnacke, Catharina Nygren DeBoussard
BACKGROUND: Medical complications after severe traumatic brain injury (S-TBI) may delay or prevent transfer to rehabilitation units and impact on long-term outcome. OBJECTIVE: Mapping of medical complications in the subacute period after S-TBI and the impact of these complications on 1-year outcome to inform healthcare planning and discussion of prognosis with relatives. SETTING: Prospective multicentre observational study. Recruitment from 6 neurosurgical centres in Sweden and Iceland...
2015: BMJ Open
Yong Min Choi, Seok Hyun Hong, Chang Hyun Lee, Jin Ho Kang, Ju Sun Oh
Neurogenic heterotopic ossification (NHO) is a process of benign bone formation and growth in soft tissues surrounding major synovial joints and is associated with central nervous system (CNS) injuries. It is a common complication in major CNS injuries, such as traumatic brain injury, spinal cord injury, and stroke. Here, we report the case of a 72-year-old male, who experienced a traumatic brain injury and painful chronic NHO around the left hip joint. Three applications of extracorporeal shock wave therapy (ESWT) were administered to the area of NHO, which resulted in pain relief and an improvement in the loss of motion in the left hip joint...
April 2015: Annals of Rehabilitation Medicine
François Genêt, Irina Kulina, Cedryck Vaquette, Frédéric Torossian, Susan Millard, Allison R Pettit, Natalie A Sims, Adrienne Anginot, Bernadette Guerton, Ingrid G Winkler, Valérie Barbier, Jean-Jacques Lataillade, Marie-Caroline Le Bousse-Kerdilès, Dietmar W Hutmacher, Jean-Pierre Levesque
Neurological heterotopic ossification (NHO) is the abnormal formation of bone in soft tissues as a consequence of spinal cord or traumatic brain injury. NHO causes pain, ankyloses, vascular and nerve compression and delays rehabilitation in this high-morbidity patient group. The pathological mechanisms leading to NHO remain unknown and consequently there are no therapeutic options to prevent or reduce NHO. Genetically modified mouse models of rare genetic forms of heterotopic ossification (HO) exist, but their relevance to NHO is questionable...
June 2015: Journal of Pathology
Mary Alexis Iaccarino, Saurabha Bhatnagar, Ross Zafonte
Traumatic brain injury (TBI) is a growing problem in the US, with significant morbidity and economic implications. This diagnosis spans a wide breath of injuries from concussion to severe TBI. Thus, rehabilitation is equally diverse in its treatment strategies targeting those symptoms that are functionally limiting with the ultimate goal of independence and community reintegration. In severe TBI, rehabilitation can be lifelong. Acute care rehabilitation focuses on emergence from coma and prognostication of recovery...
2015: Handbook of Clinical Neurology
Jonathan R Manara, James Taylor, Matthew Nixon
BACKGROUND: Shoulder pain after a cerebrovascular accident or traumatic brain injury is a common but often under-recognized problem. It is due to a number of causes including inferior subluxation, spasticity, adhesive capsulitis, and heterotopic ossification. Many of these are amenable to surgical intervention. METHODS: Literature review of current evidence. RESULTS: This article shows that there are multiple treatment options in this group of patients, and it is important to understand these as clinicians in delivering quality care to this complex group of patients...
May 2015: Journal of Shoulder and Elbow Surgery
Jacqueline E Reznik, Erik Biros, Steve Milanese, Susan Gordon, Anthony C Lamont, Mary P Galea
A study was undertaken to investigate the prevalence of neurogenic heterotopic ossification (NHO) in patients with traumatic brain injury (TBI) or traumatic spinal cord injury (TSCI) admitted to nonspecialized units. Methods consisted of a retrospective audit of patients, using the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM) coding system, admitted to The Townsville Hospital with TBI/TSCI between July 1, 2006, and December 31, 2012...
January 2015: Health Care Manager
Arun R Shrivats, Eric Hsu, Saadyah Averick, Molly Klimak, April C S Watt, Marlene DeMaio, Krzysztof Matyjaszewski, Jeffrey O Hollinger
BACKGROUND: Heterotopic ossification (HO) may occur after musculoskeletal trauma, traumatic brain injury, and total joint arthroplasty. As such, HO is a compelling clinical concern in both military and civilian medicine. A possible etiology of HO involves dysregulated signals in the bone morphogenetic protein osteogenic cascade. Contemporary treatment options for HO (ie, nonsteroidal antiinflammatory drugs and radiation therapy) have adverse effects associated with their use and are not biologically engineered to abrogate the molecular mechanisms that govern osteogenic differentiation...
June 2015: Clinical Orthopaedics and related Research
William E Morgan, Clare P Morgan
OBJECTIVE: The purpose of this case report is to describe the use of chiropractic care for a patient with neurogenic heterotopic ossification of the anterior longitudinal ligament in the cervical spine and soft tissues of the right hip after a traumatic brain injury and right femur fracture. CLINICAL FEATURES: A 25-year-old military officer was referred to a hospital-based chiropractic clinic with complaints of pain and stiffness of the neck and back along with reduced respiratory excursions that began several months after a motor vehicle accident in which he had a traumatic brain injury...
December 2014: Journal of Chiropractic Medicine
H Krauss, D Maier, V Bühren, F Högel
STUDY DESIGN: Retrospective study. OBJECTIVES: This study was implemented to detect risk factors for the developing of heterotopic ossifications (HOs) in spinal cord injury (SCI) patients. SETTING: This study was conducted in Murnau, Germany. METHODS: All patients from 2008-2012 with acute SCI were routinely examined by ultrasound of the hips every 2 weeks. The sub group of SCI patients suffering of HO of the hips were extracted and the incidence of developing an HO was calculated...
May 2015: Spinal Cord
Xianghong Zhang, Shuo Jie, Tang Liu, Xiangsheng Zhang
BACKGROUND: Heterotopic ossification (HO) is a rare and potentially detrimental complication of soft-tissue trauma, amputations, central nervous system injury (traumatic brain injuries, spinal cord lesions, tumors, encephalitis), vasculopathies, arthroplasties and burn injury, characterized by lamellar bone growth in non-osseous tissues such as the muscle and the joint capsule. Heterotopic ossification associated with encephalitis is rare and the occurrence of excessive, symptomatic heterotopic ossification around bilateral hips and bilateral knees is rarely described in the literature...
2014: BMC Surgery
Murat Kara, Süha Yalçın, Didem Yenigün, Tülay Tiftik, Fevziye Ünsal Malas, Levent Özçakar
Reported here is a 50-year-old man with cubital tunnel syndrome due to heterotopic ossification after traumatic brain injury. Herein, underscoring the role of ultrasonographic evaluations in the diagnosis of our patient, we suggest that ultrasonographic imaging can be a useful first-line diagnostic method for the possibility of HO and its complications. Further, due to its high spatial resolution, lack of radiation and easy applicability, we imply that US seems to overweigh in the daily practice of rehabilitation physicians...
2015: Journal of Back and Musculoskeletal Rehabilitation
Jonathan R Peterson, Oluwatobi N Eboda, R Cameron Brownley, Katherine E Cilwa, Lauren E Pratt, Sara De La Rosa, Shailesh Agarwal, Steven R Buchman, Paul S Cederna, Michael D Morris, Stewart C Wang, Benjamin Levi
Heterotopic ossification (HO) is a common and debilitating complication of burns, traumatic brain injuries, and musculoskeletal trauma and surgery. Although the exact mechanism of ectopic bone formation is unknown, mesenchymal stem cells (MSCs) capable of osteogenic differentiation are known to play an essential role. Interestingly, the prevalence of HO in the elderly population is low despite the high overall occurrence of musculoskeletal injury and orthopedic procedures. We hypothesized that a lower osteogenicity of MSCs would be associated with blunted HO formation in old compared with young mice...
January 15, 2015: Stem Cells and Development
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