Z Orthop Unfall 2019; 157(03): 301-307
DOI: 10.1055/a-0732-5946
Review/Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Heterotopic Ossification – Complication or Chance?

Article in several languages: English | deutsch
Philip Peter Roessler
1   Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Rahel Bornemann
1   Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Cornelius Jacobs
1   Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Robert Pflugmacher
1   Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Matthias Trost
2   Klinik für Orthopädie und Unfallchirurgie, Orthopädische Universitätsklinik der Ruhr-Universität Bochum am St. Josef-Hospital Bochum, Katholisches Klinikum Bochum
,
Stefanie Hölscher-Doht
3   Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederstellungschirurgie, Universitätsklinikum Würzburg
,
Hendrik Jansen
3   Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederstellungschirurgie, Universitätsklinikum Würzburg
,
Sönke Percy Frey
2   Klinik für Orthopädie und Unfallchirurgie, Orthopädische Universitätsklinik der Ruhr-Universität Bochum am St. Josef-Hospital Bochum, Katholisches Klinikum Bochum
› Author Affiliations
Further Information

Publication History

Publication Date:
15 October 2018 (online)

Abstract

So far, there has been no clear explanation of the pathophysiological relationships in the development of HO. There is little experimental data dealing with the post-traumatic inflammatory response in terms of a balance between the repair of damaged muscle cells and the opposite response in its development. There are numerous indications regarding possible predisposing factors, such as existence of surrounding tissue hypoxia or the function of pro-angiogenic (VEGF e.g.) and osteoinductive (BMP e.g.) factors. These different scientific approaches offer the opportunity to clinically intervene. In our opinion, early intervention seems to make the most sense in terms of effectiveness and recurrence of HO. An important pathomechanism seems to be chronic inflammation. Currently, non-steroidal anti-inflammatory drugs are the most commonly prescribed prophylaxis drugs. The effectiveness and efficacy of non-steroidal anti-inflammatory drugs is limited by the time-limited release and the side effect potential. Therefore, it is interesting to focus future research towards the cross-talks between immunosuppressive downregulation of the inflammatory response and its effect on the balance between muscle regeneration and the development of HO.

 
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