Heterotopic Ossification Follow-up

Updated: Jan 27, 2021
  • Author: John Speed, MBBS; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Follow-up

Further Outpatient Care

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  • Monitoring of HO maturation

    • Monitoring of HO maturation should be performed regularly.

    • In patients with functional limitations for whom surgery is a consideration, radiography should be performed every 4-6 months.

    • CT scanning and MRI may offer more precise delineation of ectopic bone, which may be helpful in preoperative planning.

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Further Inpatient Care

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  • Patients with advanced HO who undergo surgical intervention generally require hospitalization and further inpatient care. For a discussion of care following anterior hip resection surgery, see Surgical Intervention.

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Deterrence

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  • As previously stated, the prophylactic use of medications to prevent HO has been studied in individuals with SCI, with promising outcomes. [7, 8] NSAIDs do have a role in the prevention of HO and in the prevention of postoperative recurrence after the excision of HO. Radiation therapy also may be used to prevent recurrence postoperatively in some patients. [11]

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Complications

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  • Potential complications associated with surgical intervention in patients with HO include hemorrhage and postsurgical infections (see Surgical Intervention).

  • HO in patients with SCI may lead to other complications, such as pressure sores and DVT. [31, 32]

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Prognosis

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  • Approximately 20-30% of patients with SCI develop clinically evident HO, and 3-8% of them develop severe functional limitations.

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Patient Education

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  • Patient and family education is an important part of the treatment process in individuals with HO. Physical therapists may instruct patients and family members, if needed, to complete ROM exercises as instructed by the physician. Patients should also be taught to watch for signs of other potential complications when dealing with heterotopic ossification (in order, for example, to prevent pressure sores in patients with SCI).

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