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Heterotopic Ossification

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General Orthopaedics and Basic Science

Part of the book series: Orthopaedic Study Guide Series ((ORTHSTUDY))

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Abstract

Heterotopic ossification (HO) is the formation of mature cellular bone in non-osseous tissues. While the exact biological etiology is unknown, HO typically occurs spontaneously, postoperatively, or following trauma, notably after spinal cord injury or TBI (see below).

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, PA, USA

    Gregory Pereira, Nikolaos Paschos & John Kelly IV

  2. Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Nikolaos Paschos

Authors
  1. Gregory Pereira
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  2. Nikolaos Paschos
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  3. John Kelly IV
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Corresponding author

Correspondence to Gregory Pereira .

Editor information

Editors and Affiliations

  1. Harvard Medical School, Boston Children’s Hospital, Boston, MA, USA

    Nikolaos K. Paschos

  2. Royal National Orthopaedic Hospital, Institute of Orthopaedics and Musculo-Skeletal Science, U.C.London, Stanmore, Middlesex, UK

    George Bentley

Review Questions

Review Questions

What are the current recommendations for timing of surgical treatment for HO s/p general trauma?

  1. (A)

    6 months

  2. (B)

    9 months

  3. (C)

    12 months

  4. (D)

    18 months

What is the proposed MOA of prophylactic local radiation for HO?

  1. (A)

    Mechanism via inhibition of differentiation of mesenchymal cells

  2. (B)

    Mechanism via inhibition of osteoclasts

  3. (C)

    Mechanism via inhibition of osteoblast differentiation

  4. (D)

    Mechanism via inhibition of BMP pathways

What lab values are needed for the diagnosis of HO?

  1. I.

    Elevated alkaline phosphatase

  2. II.

    Elevated CRP

  3. III.

    Elevated ESR

  4. IV.

    Elevated CK

    1. (A)

      I

    2. (B)

      I, II

    3. (C)

      I, III

    4. (D)

      II, III

    5. (E)

      None of the above

What imaging modality can be used to help determine the time of surgical intervention?

  1. (A)

    Serial plain radiographs

  2. (B)

    Serial ultrasounds

  3. (C)

    Serial triphasic bone scans

  4. (D)

    CT

  5. (E)

    MRI

Which of the following are used in the prophylaxis of HO?

  1. I)

    Surgical excision

  2. II)

    Bisphosphonates

  3. III)

    NSAIDs

  4. IV)

    Radiation

  5. V)

    Methotrexate

    1. (A)

      I

    2. (B)

      I, II

    3. (C)

      II, III, IV

    4. (D)

      III, IV, V

    5. (E)

      I, IV, V

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Pereira, G., Paschos, N., Kelly, J. (2019). Heterotopic Ossification. In: Paschos, N., Bentley, G. (eds) General Orthopaedics and Basic Science. Orthopaedic Study Guide Series. Springer, Cham. https://doi.org/10.1007/978-3-319-92193-8_18

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  • DOI: https://doi.org/10.1007/978-3-319-92193-8_18

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-92191-4

  • Online ISBN: 978-3-319-92193-8

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