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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.121 SNIP: 0.228 CiteScore™: 0.17

ISSN Druckformat: 0896-2960
ISSN Online: 2162-6553

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.2016015696
pages 123-133

Heterotopic Ossification: A Review of Etiology, Diagnosis, and Clinical Management

Justice Otchere
Loma Linda University Medical Center, Physical Medicine and Rehabilitation, Loma Linda, CA 92354
Donald Hamby
Loma Linda University Medical Center, Physical Medicine and Rehabilitation, Loma Linda, CA 92354
Scott Strum
Loma Linda University Medical Center, Physical Medicine and Rehabilitation, Loma Linda, CA 92354; Loma Linda University Medical Center, Center for Pain Management, Loma Linda, CA 92354

ABSTRAKT

Heterotopic ossification (HO) is the formation of ectopic bone outside of skeletal tissue that is usually periarticular in nature. Often, but not always, it is associated with upper motor neuron lesions such as traumatic brain injury, spinal cord injury, and stroke but has been observed after major surgeries such as total hip arthroplasty and complicated elbow fractures requiring surgical intervention. Complications that can arise from HO include neurovascular impingement, compromised range of motion (ROM) of a joint, predisposition to infection, complex regional pain syndrome, and predisposition to pressure ulcer formation. Functional implications of decreased ROM of joints in rehabilitation can result in impairment of the following transfers: mobility, gait, activities of daily living, and hygienic maintenance. The primary goal of treatment focuses on halting progression, reducing caregiver burden, and maximizing joint function. Nonsurgical treatment is indicated when the disease process is diagnosed early and the affected joint is not significantly compromised. Surgical indications for HO include reduction in ROM that compromises functionality and hygienic maintenance.