Logo of The Journal of Bone & Joint Surgery (Br)
Quick search:        
          Advanced Search
Guest Access | Sign In
Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 11, 1493-1498.
doi: 10.1302/0301-620X.91B11.22305  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow My Folders
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Genet, F.
Right arrow Articles by Denormandie, P.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Genet, F.
Right arrow Articles by Denormandie, P.

Impact of late surgical intervention on heterotopic ossification of the hip after traumatic neurological injury

F. Genet, MD, Physical Medicine and Rehabilitation1; J.-L. Marmorat, MD, Orthopaedic Surgeon2; C. Lautridou, MD, Orthopaedic Surgeon2; A. Schnitzler, MD, Physical Medicine and Rehabilitation1; L. Mailhan, MD, PhD, Physical Medicine and Rehabilitation3; and P. Denormandie, MD, Orthopaedic Surgeon2

1 Service de Médecine, Physioque et de Réadaptation
2 Service de Chirurgie, Orthopédique et, Traumatologique, Hospitalier R. Poincaré, 104, Boulevard R. Poincaré, 92380, Garches, France.
3 Service de Médecine Physique, et de Réadaption, Centre Saint Marie, 167 rue, Raymond Losserand 75014, Paris, France.

Correspondence should be sent to Dr F. Genet; e-mail: francois.genet{at}rpc.aphp.fr

Heterotopic ossification (HO) of the hip after injury to the central nervous system can lead to joint ankylosis. Surgery is usually delayed to avoid recurrence, even if the functional status is affected. We report a consecutive series of patients with HO of the hip after injury to the central nervous system who required surgery in a single, specialised tertiary referral unit. As was usual practice, they all underwent CT to determine the location of the HO and to evaluate the density of the femoral head and articular surface. The outcome of surgery was correlated with the pre-, peri- and post-operative findings.

In all, 183 hips (143 patients) were included of which 70 were ankylosed. A total of 25 peri-operative fractures of the femoral neck occurred, all of which arose in patients with ankylosed hips and were associated with intra-articular lesions in 18 and severe osteopenia of the femoral head in seven. All the intra-articular lesions were predicted by CT and strongly associated with post-operative complications.

The loss of the range of movement before ankylosis is a more important factor than the maturity of the HO in deciding the timing of surgery. Early surgical intervention minimises the development of intra-articular pathology, osteoporosis and the resultant complications without increasing the risk of recurrence of HO.






(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General