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Heterotrophic bone
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Heterotrophic bone - January 25, 2001 4:37:00 PM
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WES52
Posts: 5
Joined: December 9, 2000
From: South Thomaston,ME USA
Status: offline
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I have a pt. with bilat elbow fx's who developed heterotrophic bone formation postsurgically. His ROM is very limited. He saw his surgeon last week who has decided to go back in and "clean the joints out" . It was my understanding that a dose of radiation is necessary to inhibit the excess bone formation. The surgeon however claims it isn't necessary. I'm thinking he just doesn't know as we live in East Podunk. Anyone have any experience with this condition?
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Re: Heterotrophic bone - January 26, 2001 8:43:00 AM
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DarinPT
Posts: 13
Joined: August 14, 2000
From: Galveston, TX, US
Status: offline
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Hey WES,
I know a dose of radiation has shown to decrease risk of HO formation because our ortho faculty often uses this Rx for hip and acetabular fractures post surgery.
As far as this Rx once there is evidence of HO, I don't know but would be interested. I am sure a Medline search will give you the information you need. We commonly see HO in the burn unit and I often wondered if a dose of radiation would help decrease the formation. These patients usually go to surgery for removal of the bone once it has matured.
Please post you findings. Thanks in advance.
Darin, PT
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Re: Heterotrophic bone - January 26, 2001 1:33:00 PM
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WES52
Posts: 5
Joined: December 9, 2000
From: South Thomaston,ME USA
Status: offline
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Darin,
I am a novice with the medline search. Is that the same as pubmed? Because I did a pubmed search and could find nothing pertinent. Give me a hand forum?
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Re: Heterotrophic bone - January 26, 2001 2:24:00 PM
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DarinPT
Posts: 13
Joined: August 14, 2000
From: Galveston, TX, US
Status: offline
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Use the keywords- ossification, radiation
You should see a list of studies on the topic. It looks like there are several supporting radiation with total hip replacement and acetabular ORIF in HO prophylaxis. Keinapfel's study in Arch Orthop Trauma Surg 1999 shows it was effective with THA for preventing postop HO.
Look at-
Excision and radiotherapy for HO of the elbow.
Ortho, 1999 Nov;22(11)1059
Poggi, Thomas, Johnstone
It has a small sample size of 3 patients that showed "significant gains in ROM" at 10 months after a dose of radiation given within 48 hours after surgery. No control group.
This was just a quick glance at the first page of studies. Hopefully you will find what you need somewhere in there. Good luck.
Darin Trees, PT
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Re: Heterotrophic bone - January 26, 2001 2:35:00 PM
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DarinPT
Posts: 13
Joined: August 14, 2000
From: Galveston, TX, US
Status: offline
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Oh, it's heterotopic ossification instead of heterotrophic. That may be why it didn't show up. I thought that looked weird. You must be thinking of hypertrophic scarring. TGIF!
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Re: Heterotrophic bone - January 27, 2001 4:00:00 PM
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WES52
Posts: 5
Joined: December 9, 2000
From: South Thomaston,ME USA
Status: offline
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Yes, the proper spelling makes all the difference.....
The studies show no definitive conclusion whether or not radiation helps to prevent HO formation at the elbow. Some studies say it is beneficial, others say it is not necessary. It is more widely used and accepted at the hip. Thanks for your help Darin.
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