Skip to main content
SpringerLink
Log in

Heterotopic ossification: Clinical and cellular aspects

  • Orthopedic Surgical Forum
  • Published:
Calcified Tissue International Aims and scope Submit manuscript

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Rossier AB, Bussat P, Infante F, Zender R, Courvoisier B, Muheim G, Donath A, Vasey H, Taillard W, Lagier R, Gabbiani G, Baud CA, Pouzeat JA, Very JM, Hachen HJ (1973) Current facts on paraosteo-arthropathy (POA). Paraplegia 11:36–78

    Google Scholar 

  2. Chantraine A, Minaire P (1981) Para-osteo-arthropathies: a new theory and mode of treatment. Scand J Rehab Med 13:31–37

    CAS  Google Scholar 

  3. Miller LF, O'Neill CJ (1949) Myositis ossificans in paraplegics. J Bone Joint Surg 31A:283–294

    PubMed  CAS  Google Scholar 

  4. Stoikovic JP, Bonfiglio M, Paul WD (1955) Myositis ossificans complicating poliomyelitis. Arch Phys Med Rehab 36:236–243

    CAS  Google Scholar 

  5. Mendelson L, Grosswasser Z, Najenson T, Sandbank U, Solzi P (1975) Periarticular new bone formation in patients suffering from severe head injuries. Scand J Rehab Med 7:141–145

    CAS  Google Scholar 

  6. Radt P (1970) Periarticular ectopic ossification in hemiplegics. Geriatrics 25:142–57

    PubMed  CAS  Google Scholar 

  7. Prakash V, Lin MS, Perkash I (1978) Detection of heterotopic calcification with99m Tc-pyrophosphate in spinal cord injury patients. Clin Nucl Med 3:167–169

    Article  PubMed  CAS  Google Scholar 

  8. Brooker AF, Bowerman JW, Robinson RA, Riley LH (1973) Ectopic ossification following total hip replacement: incidence and method of classification. J Bone Joint Surg 57A:1629–1632

    Google Scholar 

  9. Jowsey J, Coventry MB, Robins PR (1977) Heterotopic ossification: theoretical consideration, possible etiologic factors, and a clinical review of total hip arthroplasty patients exhibiting this phenomenon. in: The Hip, CV Mosby, St. Louis, MO, pp 210–221

    Google Scholar 

  10. Morrey BF, Adams RA, Cabanela ME (1984) Comparison of heterotopic bone after anterolateral, transtrochanteric, and posterior approaches for total hip arthroplasty. Clin Orthop 188:160–167

    PubMed  Google Scholar 

  11. Nollen, AJG, Sloof TJJH (1973) Para-articular ossifications after total hip replacement. Acta Orthop Scand 44:230–241

    PubMed  CAS  Google Scholar 

  12. Evans EB (1966) Orthopaedic measures in the treatment of severe burns. J Bone Joint Surg 48A:643–669

    Google Scholar 

  13. Orzel JA, Rudd TG (1985) Heterotopic bone formation: clinical, laboratory, and imaging correlation. J Nucl Med 26:125–132

    PubMed  CAS  Google Scholar 

  14. Burtis WJ, Lang R (1984) Chemical abnormalities. Orthop Clin N Am 15:653–669

    CAS  Google Scholar 

  15. Kjaersgaard-Andersen P, Pedersen P, Kristensen SS, Schmidt SA, Pedersen NW (1988) Serum alkaline phosphatase as an indicator of heterotopic bone following total hip arthroplasty. Clin Orthop 234:102–109

    PubMed  Google Scholar 

  16. Freed JH, Hahn H, Menter R, Dillon T (1982) The use of the three-phase bone scan in the early diagnosis of heterotopic ossification (HO) and in the evaluation of didronel therapy Paraplegia 20:208–216

    PubMed  CAS  Google Scholar 

  17. McClelland SJ, Rudolf LM (1986) Myositis ossificans following porous-ingrowth total knee replacement. Orthop Res 15:223–227

    CAS  Google Scholar 

  18. Kjaersgaard-Andersen P, Frich LH, Sojbjerg JO, Sneppen O (1989) Heterotopic bone formation following total shoulder arthroplasty. J Arthroplasty 4:99–104

    PubMed  CAS  Google Scholar 

  19. Peters WJ, Pritzker KP (1985) Massive heterotopic ossification in breast implant capsules. Aesth Plastic Surg 9:43–45

    Article  CAS  Google Scholar 

  20. Myers MA, Minton JP (1989) Heterotopic ossification within the small bowel mesentery. Arch Surg 124:982–983

    PubMed  CAS  Google Scholar 

  21. Kromann-Anderson C, Sorensen TS, Hougaard K, Zdravkovic D, Frigaard E (1980) Ectopic bone formation following Charnley hip arthroplasty. Acta Orthop Scand 51:633–638

    Google Scholar 

  22. Ahrengart L, Lindgren U (1989) Functional significance of heterotopic bone formation after total hip arthroplasty. J Arthroplasty 4:125–131

    PubMed  CAS  Google Scholar 

  23. Ritter MA, Vaughan RB (1977) Ectopic ossification after total hip arthroplasty; predisposing factors, frequency and effect on results. J Bone Joint Surg 59A:345–351

    Google Scholar 

  24. DeLee J, Ferrari A, Charnley J (1976) Ectopic bone formation following low friction arthroplasty of the hip. Clin Orthop 121:53–59

    PubMed  Google Scholar 

  25. Sundaram NA, Murphy JC (1986) Heterotopic bone formation following total hip arthroplasty in ankylosing spondylitis. Clin Orthop 207:223–226

    PubMed  Google Scholar 

  26. Fahrer H, Koch P, Ballmer P, Enzler P, Gerber N (1988) Ectopic ossification following total hip arthroplasty: Is diffuse idiopathic skeletal hyperostosis a risk factor? Br J Rheumatol 27:187–190

    Article  PubMed  CAS  Google Scholar 

  27. Blasingame JP, Resnick D, Coutts RD, Danzig LA (1981) Extensive spinal osteophytosis as a risk factor for heterotopic bone formation after total hip arthroplasty. Clin Orthop 161:191–197

    PubMed  Google Scholar 

  28. An HS, Ebraheim N, Kim K, Jackson W, Kane JT (1987) Heterotopic ossification and pseudoarthritis in the shoulder following encephalitis: a case report and review of the literature. Clin Orthop 219:291–298

    PubMed  Google Scholar 

  29. Lorber I (1953) Ectopic ossification in tuberculous meningitis. Arch Dis Child 28:98–103

    PubMed  CAS  Google Scholar 

  30. Ishikawa K, Izumi K, Kitagawa T (1982) Heterotopic ossification of the hip as a complication of tetanus. Clin Orthop 166:249–255

    PubMed  Google Scholar 

  31. Roberts PH (1968) Heterotopic ossification complicating paralysis of intracranial origin. J Bone Joint Surg 50B:70–77

    Google Scholar 

  32. Radt P (1970) Periarticular ectopic ossification in hemiplegics. Geriatrics 25:142–157

    PubMed  CAS  Google Scholar 

  33. Roberts JB, Pankratz DG (1979) The surgical treatment of heterotopic ossification at the elbow following long-term coma. J Bone Joint Surg 61A:760–763

    Google Scholar 

  34. Garland DE (1988) Clinical observations on fractures and heterotopic ossification in the spinal cord and traumatic brain-injured populations. Clin Orthop 233:86–101

    PubMed  Google Scholar 

  35. Garland DE, O'Hallaren RM (1982) Fractures and dislocations about the elbow in the head-injured adult. Clin Orthop 168:38–41

    PubMed  Google Scholar 

  36. Spencer RF (1987) The effect of head injury on fracture healing. J Bone Joint Surg 69B:525–528

    Google Scholar 

  37. Binder SM, Rubins IM, Desjardins JV, Zukor DJ, Goltzman D (1990) Evidence for a humoral mechanism for enhanced osteogenesis after head injury. J Bone Joint Surg 72A:1144–1149

    Google Scholar 

  38. Garland DE, Shimoyama ST, Lugo C, Barras D, Gilgoff I (1989) Spinal cord insults and heterotopic ossification in the pediatric population. Clin Orthop 245:303–310

    PubMed  Google Scholar 

  39. Scher AT (1976) The incidence of ectopic bone formation in posttraumatic paraplegic patients of different racial groups. Paraplegia 14:202–206

    PubMed  CAS  Google Scholar 

  40. Lal S, Hamilton BB, Heinemann A, Betts HB (1981) Risk factors for heterotopic ossification in spinal cord injury. Arch Phys Med Rehab 70:291–292

    Google Scholar 

  41. Hassard GH (1975) Heterotopic bone formation about the hip and unilateral decubitus ulcers in spinal cord injury. Arch Phys Med Rehab 56:355–358

    CAS  Google Scholar 

  42. Ackerman LV (1958) Extra-osseous localized non-neoplastic bone and cartilage formation (so-called myositis ossificans). J Bone Joint Surg 40A:279–298

    Google Scholar 

  43. Johnson JTH (1957) Atypical myositis ossificans. J Bone Joint Surg 31A:189–194

    Google Scholar 

  44. Boyd BM Jr, Roberts WM, Miller GR (1959) Periarticular ossification following burns. South Med J 52:1048–1051

    PubMed  Google Scholar 

  45. Peterson SL, Mani MM, Crawford CM, Neff JR, Hiebert JM (1989) Postburn heterotopic ossification: insights for management decision making. J Trauma 29:365–369

    PubMed  CAS  Google Scholar 

  46. Evans EB (1978) Musculoskeletal changes complicating burns. In: Epps CH Jr (ed) Complications in orthopaedic surgery. JB Lippincott Co, Philadelphia

    Google Scholar 

  47. Munster AM, Bruck HM, Johns LA, VonPrince K, Kirkman E, Remig RL (1973) Heterotopic calcification following burns: a prospective study. J Trauma 12:1071–1074

    Google Scholar 

  48. Schiele HP, Hubbard RB, Bruck HM (1972) Radiographic changes in burns of the upper extremity. Diagn Radiol 104:13–17

    CAS  Google Scholar 

  49. Hoffer MM, Brody G, Ferlic F (1978) Excision of heterotopic ossification about elbows in patients with thermal injury. J Trauma 18:667–670

    PubMed  CAS  Google Scholar 

  50. Bhatia NN, Hoshiko MG (1982) Uterine osseus metaplasia. Obstet Gynecol 60:256–259

    PubMed  CAS  Google Scholar 

  51. Jackson DW, Feagin JA (1973) Quadriceps contusions in young athletes: relation of severity of injury to treatment and prognosis. J Bone Joint Surg 55A:95–105

    Google Scholar 

  52. Symeonides PP, Ioannides G (1972) Ossicles in the knee menisci. J Bone Joint Surg 54A:1288–1292

    Google Scholar 

  53. Jones BV, Ward MW (1980) Myositis ossificans in the biceps femoris muscles causing sciatic nerve palsy: a case report. J Bone Joint Surg 64B:506–507

    Google Scholar 

  54. Deutch I (1971) Myositis ossificans: complications of drug abuse. JAMA 216:1035

    Article  Google Scholar 

  55. Coventry MB, Scanlon PW (1981) The use of radiation to discourage ectopic bone. J Bone Joint Surg 63A:201–208

    Google Scholar 

  56. Ayers DC, Evarts CM, Parkinson JR (1986) The prevention of heterotopic ossification in high-risk patients by low-dose radiation therapy after total hip arthroplasty. J Bone Joint Surg 68A:1423–1429

    Google Scholar 

  57. Brunner R, Morscher E, Hunig R (1987) Para-articular ossification in total hip replacement: an indication for irradiation therapy. Arch Orthop Trauma Surg 106:102–107

    Article  PubMed  CAS  Google Scholar 

  58. Konski A, Weiss C, Rosier R, Poulter C, Pelligrini V, Anthony P, Evarts CM, Richardson M, Henzler M, Rubin P (1990) The use of postoperative irradiation for the prevention of heterotopic bone after total hip replacement with biologic fixation (porous coated) prosthesis: an animal model. Int J Radiat Oncol Biol Phys 18:861–865

    PubMed  CAS  Google Scholar 

  59. Konski A, Pellegrini V, Poulter C, DeVanny J, Rosier R, Evarts CM, Henzler M, Rubin P (1990) Randomized trial comparing single dose versus fractionated irradiation for prevention of heterotopic bone: a preliminary report. Int J Radiat Oncol Biol Phys 18:1139–1142

    PubMed  CAS  Google Scholar 

  60. Schmidt SA, Kjaersgaard-Anderson P, Pederson NW, Kristensen SS, Pedersen P, Nielsen JB (1988) The use of indomethacin to prevent the formation of heterotopic bone after total hip replacement. J Bone Joint Surg 770A:834–838

    Google Scholar 

  61. Elmstedt E, Lindholm TS, Nilsson OS, Tornkvist H (1985) Effect of ibuprofen on heterotopic ossification after hip replacement. Acta Orthop Scand 56:25–27

    Article  PubMed  CAS  Google Scholar 

  62. Fliesch HA, Russell RGG, Bisaz S, Muhlebauer RC, Williams DA (1970) The inhibitory effect of phosphonates on the formation of calcium phosphate crystals in vitro and on aortic and kidney calcification in vivo. Eur J Clin Invest 1:12–18

    Google Scholar 

  63. Plasmans CM, Kuypers W, Sloof T (1978) The effect of ethane-1-hydroxy-1, 1-diphosphonic acid (EHDP) on matrix-induced ectopic bone formation. Clin Orthop 132:233–243

    PubMed  CAS  Google Scholar 

  64. Thomas BJ, Amstutz JC (1985) Results of the administration of diphosphonates for the prevention of heterotopic ossification after total hip arthroplasty. J Bone Joint Surg 67A:400–404

    Google Scholar 

  65. Nijweide PJ, Burger EH, Feyen JH (1986) Cells of bone: proliferation, differentiation, and hormonal regulation. Physiol Rev 66:855–886

    PubMed  CAS  Google Scholar 

  66. Gothlin G, Ericsson JLE (1976) The osteoclast: review of ultrastructure, origin, and structure-function relationship. Clin Orthop 120:201–231

    PubMed  Google Scholar 

  67. Friedenstein AJ (1972) Determined and inducible osteogenic precursor cells. CIBA Foundation symposia, vol. 11 Hard tissue growth, repair and remineralization London, England pp 169–185

    Google Scholar 

  68. Puzas JE (1990) The osteoblast. In: Favus MJ (ed) Primer on the metabolic bone diseases and disorders of mineral metabolism. Am Soc Bone Min Res: Kelseyville, CA

    Google Scholar 

  69. Pardee AB, Dubrow R, Hamlin JL, Kletzein RF (1978) Animal cell cycle. Ann Rev Biochem 47:715–750

    Article  PubMed  CAS  Google Scholar 

  70. Zetterberg A, Larsson O (1985) Kinetic analysis of regulatory events in G1 leading to proliferation or quiescence of swiss 3T3 cells. Proc Natl Acad Sci 82:5365–5369

    Article  PubMed  CAS  Google Scholar 

  71. Tobey RA, Ley KD (1970) Regulation of initiation of DNA synthesis in chinese hamster cells. I. Production of stable reversible G1-arrested populations in suspension culture. J Cell Biol 46:151–7

    Article  PubMed  CAS  Google Scholar 

  72. Zetterberg A, Aver G (1970) Proliferative activity and cytochemical properties of nuclear chromatin related to local cell density of epithelial cells. Exp Cell Res 62:262–270

    Article  PubMed  CAS  Google Scholar 

  73. Owens GK, Geisterfer AAT, Yang YW, Komoria A (1988) Transforming growth factor-β-induced growth inhibition and cellular hypertrophy in cultured vascular smooth muscle cells. J Cell Biol 107:771–780

    Article  PubMed  CAS  Google Scholar 

  74. Pledger WJ, Stiles GD, Antoniades HN, Scher CD (1977) Induction of DNA synthesis in balb/c 3T3 cells by serum components: reevaluation of the commitment process. Proc Natl Acad Sci 74:4481–4485

    Article  PubMed  CAS  Google Scholar 

  75. Wice B, Milbrandt J, Glaser L (1987) Control of muscle differentiation in BC3HI cells by fibroblast growth factor and vandate. J Biology Chem 262:1810–1817

    CAS  Google Scholar 

  76. Kojima I, Kitaoka M, Ogata E (1990) Studies on the cycle dependency of the actions of insulin-like growth factor 1 in Balb/c 3T3 cells. J Cell Phys 143:529–533

    Article  CAS  Google Scholar 

  77. Nishimoto I, Hata Y, Ogata E, Kojima I (1987) Insulin-like growth factor II stimulates calcium influx in competent Balb/c 3T3 cells primed with epidermal growth factor. J Biol Chem 262:12120–12126

    PubMed  CAS  Google Scholar 

  78. Chambard J, Pouyssegur J (1988) TGF-β inhibits growth factor-induced DNA synthesis in hamster fibroblasts without affecting early mitogenic events. J Cell Phys 135:101–107

    Article  CAS  Google Scholar 

  79. Westermark B, Heldin C (1985) Similar action of plateletderived growth factor in the pre-replicative phase of human fibroblasts suggests a common intracellular pathway. J Cell Phys 124:43–48

    Article  CAS  Google Scholar 

  80. O'Keefe EJ, Pledger WJ (1983) A model of cell cycle control: sequential effects regulated by growth factors. Mol Cell Endocrinol 31:167–186

    Article  PubMed  Google Scholar 

  81. Hauschka PV, Mavarakos AE, Iafrati MD, Doleman SE, Klagsbrun M (1986) Growth factors in bone matrix: isolation of multiple types by affinity chromatography on heparinsepharose. J Biol Chem 261:12665–12674

    PubMed  CAS  Google Scholar 

  82. Canalis E, Raisz LG (1979) Effect of epidermal growth factor in bone formation in vitro. Endocrinology 104:862–869

    PubMed  CAS  Google Scholar 

  83. Centrella M, Canalis E (1985) Local regulators of skeletal growth: a perspective. Endocr Rev 6:544–551

    PubMed  CAS  Google Scholar 

  84. Centrella M, Massague J, Canalis E (1987) Transforming growth factor-β is a bifunctional regulator of replication and collagen synthesis in osteoblast-enriched cell cultures from fetal rat bone. J Biol Chem 262:2869–2874

    PubMed  CAS  Google Scholar 

  85. Rosier RN, O'Keefe RJ, Crabb ID, Puzas JE (1989) Transforming growth factor beta: an autocrine regulator of chondrocytes. Connect Tissue Res 20:295–301

    PubMed  CAS  Google Scholar 

  86. Urist MR, Strates BS (1970) Bone formation in implants of partially and wholly demineralized bone matrix. Clin Orthop 71:271–278

    PubMed  CAS  Google Scholar 

  87. Wang EA, Rosen V, D'Alessandro JS, Bauduy M, Cordes P, Harada T, Israel DI, Hewick RM, Kerns KM, LaPan P, Luxenberg DP, McQuaid D, Moutsatsos JK, Nove J, Wozney JM (1990) Recombinant human bone morphogenic protein induces bone formation. Proc Natl Acad Sci 87:2220–2224

    Article  PubMed  CAS  Google Scholar 

  88. Vukiceuk S, Luyten FP, Reddi AH (1990) Osteogenin inhibits proliferation and stimulates differentiation in mouse osteoblast-like cultures (MC3T3-E1). Biochem Biophys Res Comm 166:750–756

    Article  Google Scholar 

  89. Seyedin SM (1989) Osteoinduction: a report on the discovery and research of unique protein growth factors mediating bone development. Oral Surg Oral Med Oral Pathol 68:527–530

    Article  PubMed  CAS  Google Scholar 

  90. Wozney JM, Rosen V, Celeste AJ, Mitsock LM, Whitters MJ, Kriz RW, Hewick RM, Wang EA (1988) Novel regulators of bone formation: molecular clones and activities. Science 242:1528–1534

    Article  PubMed  CAS  Google Scholar 

  91. Seppa H, Grotendorst G, Seppa S, Schiffmann E, Martin GR, (1982) Platelet-derived growth factor is chemotactic for fibroblasts. J Cell Biol 92:584–588

    Article  PubMed  CAS  Google Scholar 

  92. Postlethwaite AE, Keski-Oja J, Moses HL, Kang AH (1987) Stimulation of the chemotactic migration of human fibroblasts by transforming growth factor β. J Exp Med 165:251–256

    Article  PubMed  CAS  Google Scholar 

  93. Firschein HE, Urist MR (1972) Enzyme induction, accumulation of collagen, and calcification in implants of bone matrix. Clin Orthop 84:263–275

    Article  PubMed  CAS  Google Scholar 

  94. Canalis E, Centrella M, McCarthy T (1988) Effects of basic fibroblast growth factor on bone formation in vivo. J Clin Invest. 81:1572–7

    Article  PubMed  CAS  Google Scholar 

  95. Canalis E (1981) Effect of platelet-derived growth factor on DNA and protein synthesis in cultured rat calvaria. Metabolism 30:970–975

    Article  PubMed  CAS  Google Scholar 

  96. Hock JM, Centrella M, Canalis E (1988) Insulin-like growth factor I has independent effects on bone matrix formation and cell replication. Endocrinology 122:254–260

    PubMed  CAS  Google Scholar 

  97. Mohan S, Jennings JC, Linkhart TA, Baylink DJ (1988) Primary structure of human skeletal growth factor: sequence homology with human insulin-like growth factor-II. Biochem Biophys Acta 996:44–55

    Google Scholar 

  98. Ingber DE, Folkman J (1989) Mechanochemical switching between growth and differentiation during fibroblast growth factor-stimulated angiogenesis in vitro: role of extracelluar matrix. J Cell Biol 109:317–303

    Article  PubMed  CAS  Google Scholar 

  99. Merwin JR, Anderson JM, Kocher O, Van Italle CM, Madri JA (1990) Transforming growth factor beta I modulates extracelluar matrix organization and cell-cell junctional complex formation during in vitro angiogenesis. J Cell Phys 141:117–128

    Article  Google Scholar 

  100. Roberts AB, Anzano MA, Wakefield LM, Roche NS, Stern DF, Sporn MB (1985) Type β transforming growth factor: a bifunctional regulator of cellular growth. Proc Natl Acad Sci 82:119–123

    Article  PubMed  CAS  Google Scholar 

  101. Chen TL, Mallory JB, Chang SI (1989) Modulation of transforming growth factor-β actions in rat osteoblast-like cells: the effects of bFGF and EGF. Growth Factors 1:335–345

    PubMed  CAS  Google Scholar 

  102. Pfeilschifter J, Oechsner M, Naumann A, Gronwald RGK, Minne HW, Ziegler R (1990) Stimulation of bone matrix appostion in vitro by local growth factors: a comparison between insulin-like growth factor 1, platelet-derived growth factor, and transforming growth factor β. Endocrinology 127:69–75

    Article  PubMed  CAS  Google Scholar 

  103. Puzas JE, Brand JS, Evarts CM (1987) The stimulus for bone formation. In: Brand RA (ed) The hip. CV Mosby, St Louis, pp 25–38

    Google Scholar 

  104. Puzas JE, Harper KD, Gelb DA, Alioto RJ, Sawyer JR, Rosier RN (1990) Growth factor content of pathological bone may be a determining factor for control of its mass. J Bone Mineral Res 5(suppl 2):s150

    Google Scholar 

  105. Chalmers J, Gray DH, Rush J (1975) Observations on the induction of bone in soft tissues. J Bone Joint Surg 57B:36–45

    Google Scholar 

  106. Rodan SB, Wesolowski G, Thomas K, Rodan GA (1987) Growth stimulation of rat calvaria osteoblastic cells by acidic fibroblast growth factor. Endocrinology 12:1917–1923

    Article  Google Scholar 

  107. Scher CD, Stone ME (1979) Platlet-derived growth factor prevents G0 growth arrest. Nature 281:390–392

    Article  PubMed  CAS  Google Scholar 

  108. Riegler HF, Harris CM (1976) Heterotopic bone formation after total hip arthroplasty. Clin Orthop 117:209–221

    PubMed  Google Scholar 

  109. Dejerine M, Ceillier A, Dejerine Y (1919) Para-osteo-arthropathies des paraplegiques par lesions medullaires. Rev Neurol 34:399–407

    Google Scholar 

  110. Soule AB (1945) Neurogenic ossifying fibromyopathies. A preliminary report. J Neurosurg 2:485–497

    Article  Google Scholar 

  111. Hardy AG, Dickson JW (1963) Pathological ossification in traumatic paraplegia. J Bone Joint Surg 45B:76–87

    Google Scholar 

  112. Hernandez AM, Forner JV, Fuente T, Gonzalez C, Miro R (1978) The para-articular ossifications in our paraplegics and tetraplegics: a survey of 704 patients. Paraplegia 16:272–275

    PubMed  CAS  Google Scholar 

  113. Blane CE, Perkash I (1981) True heterotopic bone in the paralyzed patient. Skel Radiol 7:21–25

    Article  CAS  Google Scholar 

  114. Lazansky M (1973) Complications revisited: the debit side of total hip replacement. Clin Orthop 95:96–103

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics, The University of Rochester, 14642, Rochester, New York, USA

    Jeffrey R. Sawyer, Mark A. Myers, Randy N. Rosier & J. Edward Puzas

Authors
  1. Jeffrey R. Sawyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mark A. Myers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Randy N. Rosier
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Edward Puzas
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sawyer, J.R., Myers, M.A., Rosier, R.N. et al. Heterotopic ossification: Clinical and cellular aspects. Calcif Tissue Int 49, 208–215 (1991). https://doi.org/10.1007/BF02556120

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02556120

Keywords

Search

Navigation