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Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2007; 17(3): 156-171
DOI: 10.1055/s-2007-956519
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© Georg Thieme Verlag KG Stuttgart · New York

Heterotope Ossifikation bei Querschnittlähmung und Schädel-Hirn-Trauma

Heterotopic Ossification in Spinal Cord Injury and Traumatic Brain InjuryM. Akbar 1 , T. M. Seyler 2 , R. Abel 3 , H. J. Gerner 1
  • 1Stiftung Orthopädische Universitätsklinik Heidelberg, Deutschland
  • 2Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Reconstruction, Sinai Hospital of Baltimore
  • 3Klinik für Querschnittgelähmte, Krankenhaus Hohe Warte Bayreuth, Deutschland
Further Information

Publication History

eingereicht: 2.9.2005

angenommen: 27.10.2006

Publication Date:
11 June 2007 (online)

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Zusammenfassung

Die Formen der hereditären und der erworbenen heterotopen Ossifikation (HO) sind bekannt. Letztere, welche die häufiger vorkommende Form ist, wird eingeteilt in traumatische (THO) und neurogene (NHO) heterotope Ossifikationen. Die neurogene heterotope Ossifikation ist eine häufige Komplikation nach Rückenmarksverletzungen mit konsekutiver Querschnitt-lähmung sowie Schädel-Hirn-Verletzungen. Die neurogene heterotope Ossifikation wird häufig nach Auftreten der ersten klinischen Symptome diagnostiziert und ist sehr schwer zu therapieren. In dieser Übersichtsarbeit werden die Inzidenz, die Lokalisation, die klinischen Zeichen und die Risikofaktoren hervorgehoben. Besonderes Augenmerk liegt auf den gebräuchlichsten diagnostischen Maßnahmen sowie Therapie-Optionen.

Abstract

There are two existing forms of heterotopic ossification: the hereditary and the acquired forms. The acquired heterotopic ossification is the most common form. It is classified in two groups, the traumatic heterotopic ossification (THO) and the neurogenic heterotopic ossification (NHO). The neurogenic heterotopic ossification (NHO) is a common complication after spinal cord injury (SCI) and after traumatic brain injury (TBI). The early diagnosis and treatment of neurogenic heterotopic ossifications is difficult. This review describes the incidence, the location, the clinical signs and the risk factors. Additionally, the different diagnostic and therapeutic methods currently used in NHO management after SCI and TBI will be discussed.

Schlüsselwörter

heterotope Ossifikation - Paraosteoarthropathie (POA) - ektope Ossifikation - Knochenneubildung - Querschnittlähmung - Schädel-Hirn-Trauma (SHT) - Diagnostik - Therapie

Key words

neurogenic heterotopic ossification - ectopic bone - spinal cord injury (SCI) - traumatic brain injury (TBI) - diagnosis - therapy

Literatur

  • 1 Dejerine AA, Ceillier A. Para-ostéoarthropathies des Paraplégiques par lésion médullaire: Etude clinique et radiographique.  Ann Med. 1918;  5 497-535
    PubMedGoogle Scholar
  • 2 Heilbrun N, Kuhn WG. Erosive bone lesions and soft tissue ossifications associated with spinal cord injuries (Paraplegia).  Radiology. 1947;  48 579-593
    PubMedGoogle Scholar
  • 3 Abramason AS. Bone disturbances in injuries to the spinal cord and cauda equina. Their prevention by ambulation.  J Bone Joint Surg. 1948;  30 ((A)) 982-988
    PubMedGoogle Scholar
  • 4 Liberson M. Soft tissue calcifications in cord lesions.  JAMA. 1953;  152 1010-1013
    PubMedGoogle Scholar
  • 5 Lodge T. Bone, joint and soft tissue changes following paraplegia.  Acta Radiol. 1956;  46 435-445
    PubMedGoogle Scholar
  • 6 Damanski M. Heterotopic ossification in paraplegia: A clinical study.  J Bone Joint Surg. 1961;  43 ((B)) 286-299
    PubMedGoogle Scholar
  • 7 Hardy AG, Dickson JW. Pathological ossification in traumatic paraplegia.  J Bone Joint Surg. 1963;  45 ((B)) 76-87
    PubMedGoogle Scholar
  • 8 Freehafer AA, Yurick R, Mast WA. Para-articular ossification in spinal cord injury.  Med Serv J Can. 1966;  22 471-478
    PubMedGoogle Scholar
  • 9 Silver JR. Heterotopic ossification. A clinical study of its possible relationship to trauma.  Paraplegia. 1969;  7 220-230
    PubMedGoogle Scholar
  • 10 Wharton GW, Morgan TH. Ankylosis in the paralyzed patient.  J Bone Joint Surg Am. 1970;  52 105-112
    PubMedGoogle Scholar
  • 11 Hassard GH. Heterotopic bone formation about the hip and unilateral decubitus ulcers in spinal cord injury.  Arch Phys Med Rehabil. 1975;  56 355-358
    PubMedGoogle Scholar
  • 12 Stover SL, Hataway CJ, Zeiger HE. Heterotopic ossification in spinal cord-injured patients.  Arch Phys Med Rehabil. 1975;  56 199-204
    PubMedGoogle Scholar
  • 13 Scher AT. The incidence of ectopic bone formation in post-traumatic paraplegic patients of different racial groups.  Paraplegia. 1976;  14 202-206
    CrossrefPubMedGoogle Scholar
  • 14 Hernandez AM, Forner JV, de la Fuente T, Gonzalez C, Miro R. The para-articular ossifications in our paraplegics and tetraplegics: a survey of 704 patients.  Paraplegia. 1978;  16 272-275
    PubMedGoogle Scholar
  • 15 Prakash V, Lin MS, Perkash I. Detection of heterotopic calcification with 99mTc-pyrophosphate in spinal cord injury patients.  Clin Nucl Med. 1978;  3 167-169
    CrossrefPubMedGoogle Scholar
  • 16 Furman R, Nicholas JJ, Jivoff L. Elevation of the serum alkaline phosphatase coincident with ectopic-bone formation in paraplegic patients.  J Bone Joint Surg Am. 1970;  52 1131-1137
    PubMedGoogle Scholar
  • 17 Goldman J. Heterotopic ossification in spinal cord injuries.  Physiotherapy. 1980;  66 219-220
    PubMedGoogle Scholar
  • 18 Blane CE, Perkash I. True heterotopic bone in the paralyzed patient.  Skeletal Radiol. 1981;  7 21-25
    PubMedGoogle Scholar
  • 19 Knudsen L, Lundberg D, Ericsson G. Myositis ossificans circumscripta in para/tetraplegics.  Scand J Rheumatol. 1982;  11 27-31
    PubMedGoogle Scholar
  • 20 Garland DE, Alday B, Venos KG, Vogt JC. Diphosphonate treatment for heterotopic ossification in spinal cord injury patients.  Clin Orthop Relat Res. 1983;  176 197-200
    PubMedGoogle Scholar
  • 21 Lal S, Hamilton BB, Heinemann A, Betts HB. Risk factors for heterotopic ossification in spinal cord injury.  Arch Phys Med Rehabil. 1989;  70 387-390
    PubMedGoogle Scholar
  • 22 Bravo-Payno P, Esclarin A, Arzoz T, Arroyo O, Labarta C. Incidence and risk factors in the appearance of heterotopic ossification in spinal cord injury.  Paraplegia. 1992;  30 740-745
    CrossrefPubMedGoogle Scholar
  • 23 73 Buschbacher R. Warfarin in prevention of heterotopic ossification.  Am J Phys Med Rehabil. 1992;  71 86-91
    CrossrefPubMedGoogle Scholar
  • 24 Wittenberg RH, Peschke U, Botel U. Heterotopic ossification after spinal cord injury. Epidemiology and risk factors.  J Bone Joint Surg Br. 1992;  74 215-218
    PubMedGoogle Scholar
  • 25 Colachis 3rd SC, Clinchot DM. The association between deep venous thrombosis and heterotopic ossification in patients with acute traumatic spinal cord injury.  Paraplegia. 1993;  31 507-512
    PubMedGoogle Scholar
  • 26 Renfree KJ, Banovac K, Hornicek FJ, Lebwohl NH, Villanueva PA, Nedd KJ. Evaluation of serum osteoblast mitogenic activity in spinal cord and head injury patients with acute heterotopic ossification.  Spine. 1994;  19 740-746
    PubMedGoogle Scholar
  • 27 Schurch B, Capaul M, Vallotton MB, Rossier AB. Prostaglandin E2 measurements: their value in the early diagnosis of heterotopic ossification in spinal cord injury patients.  Arch Phys Med Rehabil. 1997;  78 687-691
    CrossrefPubMedGoogle Scholar
  • 28 Banovac K, Gonzalez F. Evaluation and management of heterotopic ossification in patients with spinal cord injury.  Spinal Cord. 1997;  35 158-162
    CrossrefPubMedGoogle Scholar
  • 29 Banovac K, Gonzalez F, Renfree KJ. Treatment of heterotopic ossification after spinal cord injury.  J Spinal Cord Med. 1997;  20 60-65
    PubMedGoogle Scholar
  • 30 Finerman GA, Stover SL. Heterotopic ossification following hip replacement or spinal cord injury. Two clinical studies with EHDP.  Metab Bone Dis Relat Res. 1981;  3 337-342
    PubMedGoogle Scholar
  • 31 Taly AB, Nair KP, Kumar MV, Jayakumar PN, Vasudev MK, Ravishankar D, Kalaivant PL, Padankatty BS, Murali T. Heterotopic ossification in non-traumatic myelopathies.  Spinal Cord. 1999;  37 47-49
    CrossrefPubMedGoogle Scholar
  • 32 Abramson DJ, Kramberg S. Spondylitis, pathological ossification, and calcification associated with spinal cord injury.  J Bone Joint Surg. 1949;  31 ((A)) 274-283
    PubMedGoogle Scholar
  • 33 Garland DE, Shimoyama ST, Lugo C, Barras D, Gilgoff I. Spinal cord insults and heterotopic ossification in the pediatric population.  Clin Orthop Relat Res. 1989;  245 303-310
    PubMedGoogle Scholar
  • 34 Kluger G, Kochs A, Holthausen H. Heterotopic ossification in childhood and adolescence.  J Child Neurol. 2000;  15 406-413
    PubMedGoogle Scholar
  • 35 Frankel HL. Traumatic quadriplegia with ectopic ossification.  Proc R Soc Med. 1971;  64 222-223
    PubMedGoogle Scholar
  • 36 Venier LH, Ditunno Jr JF. Heterotopic ossification in the paraplegic patient.  Arch Phys Med Rehabil. 1971;  52 475-479
    PubMedGoogle Scholar
  • 37 Miller LF, O'Neill CJ. Myositis ossificans in paraplegics.  J Bone Joint Surg. 1949;  31 ((A)) 283-294
    PubMedGoogle Scholar
  • 38 Chantraine A, Minaire P. Para-osteo-arthropathies. A new theory and mode of treatment.  Scand J Rehabil Med. 1981;  13 31-37
    PubMedGoogle Scholar
  • 39 Catz A, Snir D, Groswasser Z, Mendelson L, Solzi P. Is the appearance of periarticular new bone formation related to local neurological disability?.  Paraplegia. 1992;  30 361-365
    PubMedGoogle Scholar
  • 40 Lynch C, Pont A, Weingarden SI. Heterotopic ossification in the hand of a patient with spinal cord injury.  Arch Phys Med Rehabil. 1981;  62 291-293
    PubMedGoogle Scholar
  • 41 Nicholas JJ. Ectopic bone formation in patients with spinal cord injury.  Arch Phys Med Rehabil. 1973;  54 354-359
    PubMedGoogle Scholar
  • 42 Cope R. Heterotopic ossification.  South Med J. 1990;  83 1058-1064
    PubMedGoogle Scholar
  • 43 Bell RB, Wallace CJ, Swanson HA, Brownell AK. Ossification of the lumbosacral dura and arachnoid following spinal cord trauma. Case report.  Paraplegia. 1995;  33 543-546
    PubMedGoogle Scholar
  • 44 Good AE, Solsky MA, Gulati SM. Heterotopic ossification simulating acute arthritis: a patient with stable, chronic neurologic disease.  J Rheumatol. 1983;  10 124-127
    PubMedGoogle Scholar
  • 45 Rohl K, Bosse A, Botel U. Unusual site of heterotopic ossification in the area of a laparotomy scar.  Unfallchirurg. 1993;  96 662-664
    PubMedGoogle Scholar
  • 46 Rubayi S, Ambe MK, Garland DE, Capen D. Heterotopic ossification as a complication of the staged total thigh muscles flap in spinal cord injury patients.  Ann Plast Surg. 1992;  29 41-46
    PubMedGoogle Scholar
  • 47 Hsu JD, Sakimura I, Stauffer ES. Heterotopic ossification around the hip joint in spinal cord injured patients.  Clin Orthop Relat Res. 1975;  112 165-169
    PubMedGoogle Scholar
  • 48 Nechwatal E. Prevention of heterotopic ossifications - a central problem in the early management of para and tetraplegics.  Z Orthop Ihre Grenzgeb. 1972;  110 590-596
    PubMedGoogle Scholar
  • 49 Tibone J, Sakimura I, Nickel VL, Hsu JD. Heterotopic ossification around the hip in spinal cord-injured patients. A long-term follow-up study.  J Bone Joint Surg Am. 1978;  60 769-775
    PubMedGoogle Scholar
  • 50 Rossier AB, Bussat P, Infante F, Zender R, Courvoisier B, Muhelm G, Donath A, Vasey H, Taillard W, Lagier R, Gabbiani G, Baud CA, Pouezat JA, Very JM, Hachen HJ. Current facts of para-osteo-arthropathy (POA).  Paraplegia. 1973;  11 38-78
    PubMedGoogle Scholar
  • 51 Garland DE, Orwin JF. Resection of heterotopic ossification in patients with spinal cord injuries.  Clin Orthop Relat Res. 1989;  242 169-176
    PubMedGoogle Scholar
  • 52 Kim SW, Wu SY, Kim RC. Computerized quantitative radionuclide assessment of heterotopic ossification in spinal cord injury patients.  Paraplegia. 1992;  30 803-807
    PubMedGoogle Scholar
  • 53 Garland DE. A clinical perspective on common forms of acquired heterotopic ossification.  Clin Orthop Relat Res. 1991;  263 13-29
    PubMedGoogle Scholar
  • 54 Stover SL, Niemann KM, Tulloss JR. Experience with surgical resection of heterotopic bone in spinal cord injury patients.  Clin Orthop Relat Res. 1991;  263 71-77
    PubMedGoogle Scholar
  • 55 Garland DE, Blum CE, Waters RL. Periarticular heterotopic ossification in head-injured adults. Incidence and location.  J Bone Joint Surg Am. 1980;  62 1143-1146
    PubMedGoogle Scholar
  • 56 Abel R, Meiners T, Gerner HJ. Die Resektion von heterotopen Ossifikationen des Hüftgelenks Querschnittgelähmter.  Operat Orthop Traumatol. 2002;  14 16-28
    PubMedGoogle Scholar
  • 57 Stockhammer G, Reindl H, Saltuari L, Spogler F, Benedetto K, Kadlez R, Frischhut B. Peri-articular calcinosis after craniocerebral trauma - the natural course and treatment concepts.  Orthopade. 1992;  21 346-352
    PubMedGoogle Scholar
  • 58 Garland DE. Clinical observations on fractures and heterotopic ossification in the spinal cord and traumatic brain injured populations.  Clin Orthop Relat Res. 1988;  233 86-101
    PubMedGoogle Scholar
  • 59 Garland DE, Alday B, Venos KG. Heterotopic ossification and HLA antigens.  Arch Phys Med Rehabil. 1984;  65 531-532
    PubMedGoogle Scholar
  • 60 Chantraine A, Nusgens B, Lapiere CM. Biochemical analysis of heterotopic ossification in spinal cord injury patients.  Paraplegia. 1995;  33 398-401
    PubMedGoogle Scholar
  • 61 Bidner SM, Rubins IM, Desjardins JV, Zukor DJ, Goltzman D. Evidence for a humoral mechanism for enhanced osteogenesis after head injury.  J Bone Joint Surg Am. 1990;  72 1144-1149
    PubMedGoogle Scholar
  • 62 Stover SL, Niemann KM, Miller JM. Disodium etidronate in the prevention of postoperative recurrence of heterotopic ossification in spinal-cord injury patients.  J Bone Joint Surg Am. 1976;  58 683-688
    PubMedGoogle Scholar
  • 63 Orzel JA, Rudd TG. Heterotopic bone formation: clinical, laboratory, and imaging correlation.  J Nucl Med. 1985;  26 125-132
    PubMedGoogle Scholar
  • 64 Benassy J, Mazabraud A, Diveres J. Neurogenic osteogenesis.  Rev Chir Orthop Reparatrice Appar Mot. 1963;  49 95-116
    PubMedGoogle Scholar
  • 65 Buring K. On the origin of cells in heterotopic bone formation.  Clin Orthop Relat Res. 1975;  110 293-301
    CrossrefPubMedGoogle Scholar
  • 66 Cassar-Pullicino VN, McClelland M, Badwan DA, McCall IW, Pringle RG, el Masry W. Sonographic diagnosis of heterotopic bone formation in spinal injury patients.  Paraplegia. 1993;  31 40-50
    CrossrefPubMedGoogle Scholar
  • 67 Puzas JE, Miller MD, Rosier RN. Pathologic bone formation.  Clin Orthop Relat Res. 1989;  245 269-281
    PubMedGoogle Scholar
  • 68 Nollen AJ. Effects of ethylhydroxydiphosphonate (EHDP) on heterotopic ossification.  Acta Orthop Scand. 1986;  57 358-361
    PubMedGoogle Scholar
  • 69 Kewalramani LS. Ectopic ossification.  Am J Phys Med. 1977;  56 99-121
    PubMedGoogle Scholar
  • 70 Keenan MAE, Haider T. The formation of heterotopic ossification after traumatic brain injur: a biopsy study with ultrastructural analysis.  J Head Trauma Rehabil. 1996;  11 8-22
    PubMedGoogle Scholar
  • 71 Jensen LL, Halar E, Little JW, Brooke MM. Neurogenic heterotopic ossification.  Am J Phys Med. 1987;  66 351-363
    PubMedGoogle Scholar
  • 72 Wlodarski KH. Bone histogenesis mediated by nonosteogenic cells.  Clin Orthop Relat Res. 1991;  272 8-15
    PubMedGoogle Scholar
  • 73 Kurer MH, Khoker MA, Dandona P. Human osteoblast stimulation by sera from paraplegic patients with heterotopic ossification.  Paraplegia. 1992;  30 165-168
    PubMedGoogle Scholar
  • 74 Ekelund A, Brosjo O, Nilsson OS. Experimental induction of heterotopic bone.  Clin Orthop Relat Res. 1991;  263 102-112
    PubMedGoogle Scholar
  • 75 Mohan S, Baylink DJ. Bone growth factors.  Clin Orthop Relat Res. 1991;  263 30-48
    PubMedGoogle Scholar
  • 76 Sawyer JR, Myers MA, Rosier RN, Puzas JE. Heterotopic ossification: clinical and cellular aspects.  Calcif Tissue Int. 1991;  49 208-215
    PubMedGoogle Scholar
  • 77 Smith R, Triffitt JT. Bones in muscles: the problems of soft tissue ossification.  Q J Med. 1986;  61 985-990
    PubMedGoogle Scholar
  • 78 Major P, Resnick D, Greenway G. Heterotopic ossification in paraplegia: a possible disturbance of the paravertebral venous plexus.  Radiology. 1980;  136 797-799
    PubMedGoogle Scholar
  • 79 Lotta S, Scelsi L, Scelsi R. Microvascular changes in the lower extremities of paraplegics with heterotopic ossification.  Spinal Cord. 2001;  39 595-598
    CrossrefPubMedGoogle Scholar
  • 80 Rush PJ. The rheumatic manifestations of traumatic spinal cord injury.  Semin Arthritis Rheum. 1989;  19 77-89
    CrossrefPubMedGoogle Scholar
  • 81 Rodriguez GP, Claus-Walker J, Kent MC, Garza HM. Collagen metabolite excretion as a predictor of bone- and skin-related complications in spinal cord injury.  Arch Phys Med Rehabil. 1989;  70 442-444
    CrossrefPubMedGoogle Scholar
  • 82 Daud O, Sett P, Burr RG, Silver JR. The relationship of heterotopic ossification to passive movements in paraplegic patients.  Disabil Rehabil. 1993;  15 114-118
    PubMedGoogle Scholar
  • 83 Michelsson JE, Rauschning W. Pathogenesis of experimental heterotopic bone formation following temporary forcible exercising of immobilized limbs.  Clin Orthop Relat Res. 1983;  176 265-272
    PubMedGoogle Scholar
  • 84 Michelsson JE, Granroth G, Andersson LC. Myositis ossificans following forcible manipulation of the leg. A rabbit model for the study of heterotopic bone formation.  J Bone Joint Surg Am. 1980;  62 811-815
    PubMedGoogle Scholar
  • 85 Hossack DW, King A. Neurogenic heterotopic ossification.  Med J Aust. 1967;  1 326-328
    PubMedGoogle Scholar
  • 86 Snoecx M, De Muynck M, Van Laere M. Association between muscle trauma and heterotopic ossification in spinal cord injured patients: reflections on their causal relationship and the diagnostic value of ultrasonography.  Paraplegia. 1995;  33 464-468
    CrossrefPubMedGoogle Scholar
  • 87 High WB. Effects of orally administered prostaglandin E-2 on cortical bone turnover in adult dogs: a histomorphometric study.  Bone. 1987;  8 363-373
    CrossrefPubMedGoogle Scholar
  • 88 Jee WS, Ueno K, Deng YP, Woodbury DM. The effects of prostaglandin E2 in growing rats: increased metaphyseal hard tissue and cortico-endosteal bone formation.  Calcif Tissue Int. 1985;  37 148-157
    CrossrefPubMedGoogle Scholar
  • 89 Jee WS, Ueno K, Kimmel DB, Woodbury DM, Price P, Woodbury LA. The role of bone cells in increasing metaphyseal hard tissue in rapidly growing rats treated with prostaglandin E2.  Bone. 1987;  8 171-178
    CrossrefPubMedGoogle Scholar
  • 90 Brooker AF, Bowerman JW, Robinson RA, Riley Jr LH. Ectopic ossification following total hip replacement. Incidence and a method of classification.  J Bone Joint Surg Am. 1973;  55 1629-1632
    PubMedGoogle Scholar
  • 91 Toom A, Fischer K, Martson A, Rips L, Haviko T. Inter-observer reliability in the assessment of heterotopic ossification: proposal of a combined classification.  Int Orthop. 2005;  29 156-159
    CrossrefPubMedGoogle Scholar
  • 92 Arcq M. Ectopic ossification: a complication after total hip replacement.  Arch Orthop Unfallchir. 1973;  77 108-131
    CrossrefPubMedGoogle Scholar
  • 93 DeLee J, Ferrari A, Charnley J. Ectopic bone formation following low friction arthroplasty of the hip.  Clin Orthop Relat Res. 1976;  121 53-59
    PubMedGoogle Scholar
  • 94 Schmidt J, Hackenbroch MH. A new classification for heterotopic ossifications in total hip arthroplasty considering the surgical approach.  Arch Orthop Trauma Surg. 1996;  115 339-343
    PubMedGoogle Scholar
  • 95 Della Valle AG, Ruzo PS, Pavone V, Tolo E, Mintz DN, Salvati EA. Heterotopic ossification after total hip arthroplasty: a critical analysis of the Brooker classification and proposal of a simplified rating system.  J Arthroplasty. 2002;  17 870-875
    CrossrefPubMedGoogle Scholar
  • 96 Roche MB, Jostes FA. Ectopic bone deposits. A paraplegic complication.  Am J Surg. 1948;  75 633-636
    CrossrefPubMedGoogle Scholar
  • 97 Blankenship LD, Strommen JA. 27-year-old man with a swollen leg.  Mayo Clin Proc. 2000;  75 977-980
    PubMedGoogle Scholar
  • 98 Rosin AJ. Ectopic calcification around joints of paralysed limbs in hemiplegia, diffuse brain damage, and other neurological diseases.  Ann Rheum Dis. 1975;  34 499-505
    PubMedGoogle Scholar
  • 99 Tow AP, Kong KH. Prolonged fever and heterotopic ossification in a C4 tetraplegic patient. Case report.  Paraplegia. 1995;  33 170-174
    CrossrefPubMedGoogle Scholar
  • 100 Gerner HJ, Graul EH, Graul H, Michelbrink A. Die Paraosteoarthropathie (POA) bei Querschnittgelähmten. In: Graul EH, Püttner S (Hrsg.) Medizin und Grenzgebiete - Perspektiven für die 90er Jahre, Band 2. Medice-Hausdruck, Iserlohn 1991: 1011-1022
    Google Scholar
  • 101 Gerner HJ. Prophylaxe bei Querschnittgelähmten. In: Weber U, Schöndorf T (Hrsg.) Thrombose - Embolie. Thieme, Stuttgart 1988: 100-103
    Google Scholar
  • 102 Schäffner C, Abel R, Fromm B, Gerner HJ. Sind heterotope Ossifikationen (HO) der Hüfte bei Querschnittgelähmten mit Thrombosen assoziiert?.  Orthopädische Praxis. 2000;  13 12-14
    PubMedGoogle Scholar
  • 103 Yue CC, Regier A, Kushner I. Heterotopic ossification presenting as arthritis.  J Rheumatol. 1985;  12 769-772
    PubMedGoogle Scholar
  • 104 Lefkoe TP, Cardenas DD. Reflex sympathetic dystrophy of the lower extremity in tetraplegia: case report.  Spinal Cord. 1996;  34 239-242
    PubMedGoogle Scholar
  • 105 Orzel JA, Rudd TG, Nelp WB. Heterotopic bone formation (myositis ossificans) and lower-extremity swelling mimicking deep-venous disease.  J Nucl Med. 1984;  25 1105-1107
    PubMedGoogle Scholar
  • 106 Wharton GW. Heterotopic ossification.  Clin Orthop Relat Res. 1975;  112 142-149
    PubMedGoogle Scholar
  • 107 Couvee LM. Heterotopic ossification and the surgical treatment of serious contractures.  Paraplegia. 1971;  9 89-94
    PubMedGoogle Scholar
  • 108 Yarkony GM, Bass LM, Keenan 3rd V, Meyer Jr PR. Contractures complicating spinal cord injury: incidence and comparison between spinal cord centre and general hospital acute care.  Paraplegia. 1985;  23 265-271
    PubMedGoogle Scholar
  • 109 Laurin NR, Powe JE, Pavlosky WF, Driedger AA. Multimodality imaging of early heterotopic bone formation.  Can Assoc Radiol J. 1990;  41 93-95
    PubMedGoogle Scholar
  • 110 Kim SW, Charter RA, Chai CJ, Kim SK, Kim ES. Serum alkaline phosphatase and inorganic phosphorus values in spinal cord injury patients with heterotopic ossification.  Paraplegia. 1990;  28 441-447
    PubMedGoogle Scholar
  • 111 Chantraine A, Very JM, Baud CA. A biophysical study of posttraumatic ectopic ossification. A case report.  Clin Orthop Relat Res. 1990;  255 289-292
    PubMedGoogle Scholar
  • 112 Mead S, Cain HD, Kelly RE, Liebgold H. Periarticular calcification in paraplegics: attempted treatment with disodium edetate.  Paraplegia. 1963;  104 62-68
    PubMedGoogle Scholar
  • 113 Nechwatal E. Early recognition of heterotopic calcifications by means of alkaline phosphatase.  Paraplegia. 1973;  11 79-85
    PubMedGoogle Scholar
  • 114 Bolger JT. Heterotopic bone formation and alkaline phosphatase.  Arch Phys Med Rehabil. 1975;  56 36-39
    PubMedGoogle Scholar
  • 115 Thomas EA, Cassar-Pullicino VN, McCall IW. The role of ultrasound in the early diagnosis and management of heterotopic bone formation.  Clin Radiol. 1991;  43 190-196
    CrossrefPubMedGoogle Scholar
  • 116 Maier D. Heterotopic ossification after spinal cord injury: Management through early diagnosis and therapy.  Orthopade. 2005;  34 120 122-127
    CrossrefPubMedGoogle Scholar
  • 117 Fornage BD, Eftekhari F. Sonographic diagnosis of myositis ossificans.  J Ultrasound Med. 1989;  8 463-466
    PubMedGoogle Scholar
  • 118 Kramer FL, Kurtz AB, Rubin C, Goldberg BB. Ultrasound appearance of myositis ossificans.  Skeletal Radiol. 1979;  4 19-20
    CrossrefPubMedGoogle Scholar
  • 119 Peck RJ, Metreweli C. Early myositis ossificans: a new echographic sign.  Clin Radiol. 1988;  39 586-588
    CrossrefPubMedGoogle Scholar
  • 120 Bodley R, Jamous A, Short D. Ultrasound in the early diagnosis of heterotopic ossification in patients with spinal injuries.  Paraplegia. 1993;  31 500-506
    CrossrefPubMedGoogle Scholar
  • 121 Scola FH, Parziale JR. Ultrasonographic diagnosis of heterotopic ossification mimicking deep vein thrombosis.  J Clin Ultrasound. 1991;  19 55-57
    CrossrefPubMedGoogle Scholar
  • 122 van Kuijk AA, Geurts AC, van Kuppevelt HJ. Neurogenic heterotopic ossification in spinal cord injury.  Spinal Cord. 2002;  40 313-326
    CrossrefPubMedGoogle Scholar
  • 123 Tanaka T, Rossier AB, Hussey RW, Ahnberg DS, Treves S. Quantitative assessment of para-osteo-arthropathy and its maturation on serial radionuclide bone images.  Radiology. 1977;  123 217-221
    PubMedGoogle Scholar
  • 124 Suzuki Y, Hisada K, Takeda M. Demonstration of myositis ossificans by 99mTc pyrophosphate bone scanning.  Radiology. 1974;  111 ((3)) 663-664
    PubMedGoogle Scholar
  • 125 Tyler JL, Derbekyan V, Lisbona R. Early diagnosis of myositis ossificans with Tc-99 m diphosphonate imaging.  Clin Nucl Med. 1984;  9 256-258
    CrossrefPubMedGoogle Scholar
  • 126 Freed JH, Hahn H, Menter R, Dillon T. The use of the three-phase bone scan in the early diagnosis of heterotopic ossification (HO) and in the evaluation of Didronel therapy.  Paraplegia. 1982;  20 208-216
    PubMedGoogle Scholar
  • 127 Drane WE. Myositis ossificans and the three-phase bone scan.  AJR Am J Roentgenol. 1984;  142 179-180
    PubMedGoogle Scholar
  • 128 Nagaraj N, Elgazzar AH, Fernandez-Ulloa M. Heterotopic ossification mimicking infection. Scintigraphic evaluation.  Clin Nucl Med. 1995;  20 763-766
    PubMedGoogle Scholar
  • 129 Muheim G, Donath A, Rossier AB. Serial scintigrams in the course of ectopic bone formation in paraplegic patients.  Am J Roentgenol Radium Ther Nucl Med. 1973;  118 865-869
    PubMedGoogle Scholar
  • 130 Banovac K, Gonzalez F, Wade N, Bowker JJ. Intravenous disodium etidronate therapy in spinal cord injury patients with heterotopic ossification.  Paraplegia. 1993;  31 660-666
    PubMedGoogle Scholar
  • 131 Zeanah WR, Hudson TM. Myositis ossificans: radiologic evaluation of two cases with diagnostic computed tomograms.  Clin Orthop Relat Res. 1982;  168 187-191
    PubMedGoogle Scholar
  • 132 Bressler EL, Marn CS, Gore RM, Hendrix RW. Evaluation of ectopic bone by CT.  AJR Am J Roentgenol. 1987;  148 931-935
    PubMedGoogle Scholar
  • 133 Yaghmai I. Myositis ossificans: diagnostic value of arteriography.  AJR Am J Roentgenol. 1977;  128 811-816
    PubMedGoogle Scholar
  • 134 Lindholm TS, Bauer FC, Rindell K. High doses of the diphosphonate EHDP for the prevention of heterotopic ossification. An experimental and clinical study.  Scand J Rheumatol. 1987;  16 33-39
    PubMedGoogle Scholar
  • 135 Russell RG, Fleisch H. Pyrophosphate and diphosphonates in skeletal metabolism. Physiological, clinical and therapeutic aspects.  Clin Orthop Relat Res. 1975;  108 241-263
    CrossrefPubMedGoogle Scholar
  • 136 Russell RG, Smith R. Diphosphonates. Experimental and clinical aspects.  J Bone Joint Surg Br. 1973;  55 66-86
    PubMedGoogle Scholar
  • 137 Mahy PR, Urist MR. Experimental heterotopic bone formation induced by bone morphogenetic protein and recombinant human interleukin-1B.  Clin Orthop Relat Res. 1988;  237 236-244
    PubMedGoogle Scholar
  • 138 Banovac K. The effect of etidronate on late development of heterotopic ossification after spinal cord injury.  J Spinal Cord Med. 2000;  23 40-44
    PubMedGoogle Scholar
  • 139 Garland DE. Clinical observations on fractures and heterotopic ossification in the spinal cord and traumatic brain injured populations.  Clin Orthop Relat Res. 1988;  233 86-101
    PubMedGoogle Scholar
  • 140 Stover SL, Hahn HR, Miller 3rd JM. Disodium etidronate in the prevention of heterotopic ossification following spinal cord injury (preliminary report).  Praplegia. 1976;  14 146-156
    PubMedGoogle Scholar
  • 141 Ono K, Takaoka K, Takahashi H, Otani K, Yoshikawa S. A double-blind study of EHDP on heterotopic ossification after spinal cord injury using placebo.  Rinsho Hyoka. 1988;  16
    PubMedGoogle Scholar
  • 142 Haran M, Bhuta T, Lee B. Pharmacological interventions for treating acute heterotopic ossification.  Cochrane Database Syst Rev. 2004;  4 , CD003321
    PubMedGoogle Scholar
  • 143 Gerner HJ. Die Querschnittlähmung: Erstversorgung, Behandlungsstrategien, Rehabilitation. Berlin: Blackwell Wissenschafts-Verlag GmbH 1992: 113-119
  • 144 Kjaersgaard-Andersen P, Nafei A, Teichert G, Kristensen O, Schmidt SA, Keller J, Lucht U. Indomethacin for prevention of heterotopic ossification. A randomized controlled study in 41 hip arthroplasties.  Acta Orthop Scand. 1993;  64 639-642
    PubMedGoogle Scholar
  • 145 Kjaersgaard-Andersen P, Schmidt SA. Total hip arthroplasty. The role of antiinflammatory medications in the prevention of heterotopic ossification.  Clin Orthop Relat Res. 1991;  263 78-86
    PubMedGoogle Scholar
  • 146 Ahrengart L, Lindgren U, Reinholt FP. Comparative study of the effects of radiation, indomethacin, prednisolone, and ethane-1-hydroxy-1,1-diphosphonate (EHDP) in the prevention of ectopic bone formation.  Clin Orthop Relat Res. 1988;  229 265-273
    PubMedGoogle Scholar
  • 147 Fransen M, Neal B. Non-steroidal anti-inflammatory drugs for preventing heterotopic bone formation after hip arthroplasty.  Cochrane Database Syst Rev. 2004;  3 , CD001160
    PubMedGoogle Scholar
  • 148 Vastel L, Rosencher N, Siney H, Courpied JP. Prevention of heterotopic ossification in hip arthroplasty: effectiveness of selective Cox-2 inhibitors (celecoxib) versus ketoprofen.  Rev Chir Orthop Reparatrice Appar Mot. 2005;  91 64-69
    PubMedGoogle Scholar
  • 149 Laborde A, Hermier M, Cotton F. Clinical Vignette. Sciatic nerve entrapement secondary to heterotopic ossification: imaging findings and potential effects of selective cox-2 inhibitors.  Rheumatology (Oxford). 2005;  44 110
    CrossrefPubMedGoogle Scholar
  • 150 Banovac K, Williams JM, Patrick LD, Levi A. Prevention of heterotopic ossification after spinal cord injury with COX-2 selective inhibitors (refocoxib).  Spinal Cord. 2004;  42 707-710
    CrossrefPubMedGoogle Scholar
  • 151 Romano CL, Duci D, Romano D, Mazza M, Meani E. Celecoxib versus indomethacin in the prevention of heterotopic ossification after total hip arthroplasty.  J Arthroplasty. 2004;  19 14-18
    CrossrefPubMedGoogle Scholar
  • 152 Fijn R, Koorevaar RT, Brouwers JR. Prevention of heterotopic ossification after total hip replacement with NSAIDs.  Pharm World Sci. 2003;  25 138-145
    CrossrefPubMedGoogle Scholar
  • 153 Juni P, Nartey L, Reichenbach S, Sterchi R, Dieppe PA, Egger M. Risk of cardiovascular events and rofecoxib: cumulative meta-analysis.  Lancet. 2004;  364 2021-2029
    CrossrefPubMedGoogle Scholar
  • 154 Chan KT. Heterotopic ossification in traumatic brain injury.  Am J Phys Med Rehabil. 2005;  84 145-146
    CrossrefPubMedGoogle Scholar
  • 155 Linan E, O'Dell MW, Pierce JM. Continuous passive motion in the management of heterotopic ossification in a brain injured patient.  Am J Phys Med Rehabil. 2001;  80 614-617
    CrossrefPubMedGoogle Scholar
  • 156 Brissot R, Lassalle A, Vincendeau S, Polard JL, Fouche M, Ninubona D, Mahieux G, Chaperon J, Lobel B. Treatment of heterotopic ossification by extracorporeal shock waves: 26 patients.  Ann Readapt Med Phys. 2005;  48 581-589
    PubMedGoogle Scholar
  • 157 Ayers DC, Pellegrini Jr VD, Evarts CM. Prevention of heterotopic ossification in high-risk patients by radiation therapy.  Clin Orthop Relat Res. 1991;  263 87-93
    PubMedGoogle Scholar
  • 158 Coventry MB, Scanlon PW. The use of radiation to discourage ectopic bone. A nine-year study in surgery about the hip.  J Bone Joint Surg Am. 1981;  63 201-208
    PubMedGoogle Scholar
  • 159 DeFlitch CJ, Stryker JA. Postoperative hip irradiation in prevention of heterotopic ossification: causes of treatment failure.  Radiology. 1993;  188 265-270
    PubMedGoogle Scholar
  • 160 Pellegrini Jr VD, Gregoritch SJ. Preoperative irradiation for prevention of heterotopic ossification following total hip arthroplasty.  J Bone Joint Surg Am. 1996;  78 870-881
    PubMedGoogle Scholar
  • 161 Schaeffer MA, Sosner J. Heterotopic ossification: treatment of established bone with radiation therapy.  Arch Phys Med Rehabil. 1995;  76 284-286
    CrossrefPubMedGoogle Scholar
  • 162 Craven PL, Urist MR. Osteogenesis by radioisotope labelled cell populations in implants of bone matrix under the influence of ionizing radiation.  Clin Orthop Relat Res. 1971;  76 231-233
    PubMedGoogle Scholar
  • 163 Sautter-Bihl ML, Liebermeister E, Heinze HG, Nanassy A, Stoltze D. The radiotherapy of heterotopic ossifications in paraplegics.  The preliminary results Strahlenther Onkol. 1995;  171 454-459
    PubMedGoogle Scholar
  • 164 Sautter-Bihl ML, Hultenschmidt B, Liebermeister E, Nanassy A. Fractionated and single-dose radiotherapy for heterotopic bone formation in patients with spinal cord injury. A phase-I/II study.  Strahlenther Onkol. 2001;  177 200-205
    CrossrefPubMedGoogle Scholar
  • 165 van Kuijk AA, van Kuppevelt HJ, van der Schaaf DB. Osteonecrosis after treatment for heterotopic ossification in spinal cord injury with the combination of surgery, irradiation, and an NSAID.  Spinal Cord. 2000;  38 319-324
    CrossrefPubMedGoogle Scholar
  • 166 Brady LW. Radiation-induced sarcomas of bone.  Skeletal Radiol. 1979;  4 72-78
    PubMedGoogle Scholar
  • 167 Kim JH, Chu FC, Woodard HQ, Melamed MR, Huvos A, Cantin J. Radiation-induced soft-tissue and bone sarcoma.  Radiology. 1978;  129 501-508
    Google Scholar
  • 168 McAuliffe JA, Wolfson AH. Early excision of heterotopic ossification about the elbow followed by radiation therapy.  J Bone Joint Surg Am. 1997;  79 749-755
    PubMedGoogle Scholar
  • 169 Pakos EE, Ioannidis JP. Radiotherapy vs. nonsteroidal anti-inflammatory drugs for the prevention of heterotopic ossification after major hip procedures: a meta-analysis of randomized trials.  Int Radiat Oncol Biol Phys. 2004;  60 888-895
    CrossrefPubMedGoogle Scholar
  • 170 Banovac K, Sherman AL, Estores IM, Banovac F. Prevention and treatment of heterotopic ossification after spinal cord injury.  J Spinal Cord Med. 2004;  27 376-382
    PubMedGoogle Scholar
  • 171 Michaelis LS. Orthopaedic surgery of the limbs in paraplegia. Berlin-Göttingen-Heidelberg: Springer 1964
  • 172 Armstrong-Ressy CT, Weiss AA, Ebel A. Results of surgical treatment of extraosseous ossification in paraplegia.  N Y State J Med. 1959;  59 2548-2553
    PubMedGoogle Scholar
  • 173 Stover SL, Niemann KM, Tulloss JR. Experience with surgical resection of heterotopic bone in spinal cord injury patients.  Clin Orthop Relat Res. 1991;  263 71-77
    PubMedGoogle Scholar
  • 174 Meiners T, Abel R, Bohm V, Gerner HJ. Resection of heterotopic ossification of the hip in spinal cord injured patients.  Spinal Cord. 1997;  35 443-445
    CrossrefPubMedGoogle Scholar
  • 175 Subbarao JV, Nemchausky BA, Gratzer M. Resection of heterotopic ossification and Didronel therapy-regaining wheelchair independence in the spinal cord injured patient.  J Am Paraplegia Soc. 1987;  10 3-7
    PubMedGoogle Scholar
  • 176 Ellerin BE, Helfet D, Parikh S, Hotchkiss RN, Levin N, Nisce L, Nori D, Moni J. Current therapy in the management of heterotopic ossification of the elbow: a review with case studies.  Am J Phys Med Rehabil. 1999;  78 259-271
    CrossrefPubMedGoogle Scholar
  • 177 Jamil F, Subbarao JV, Banaovac K, El Masry WS, Bergman SB. Management of immature heterotopic ossification (HO) of the hip.  Spinal Cord. 2002;  40 388-395
    CrossrefPubMedGoogle Scholar
  • 178 Gacon G, Deidier C, Rhenter JL, Minaire P. Ectopic bone formation in neurological lesions.  Rev Chir Orthop Reparatrice Appar Mot. 1978;  64 375-390
    PubMedGoogle Scholar
  • 179 Freebourn TM, Barber DB, Able AC. The treatment of immature heterotopic ossification in spinal cord injury with combination surgery, radiation therapy and NSAID.  Spinal Cord. 1999;  37 50-53
    CrossrefPubMedGoogle Scholar
  • 180 Biering-Sorensen F, Tondevold E. Indomethacin and disodium etidronate for the prevention of recurrence of heterotopic ossification after surgical resection. Two case reports.  Paraplegia. 1993;  31 513-515
    CrossrefPubMedGoogle Scholar
  • 181 Becker SW, Rohl K, Weidt F. Endoprosthesis in paraplegics with periarticular ossification of the hip.  Spinal Cord. 2003;  41 29-33
    CrossrefPubMedGoogle Scholar
  • 182 Abel R, Böhm V, Meiners T, Gerner HJ. Surgical treatment of Neurogenic Heterotopic Ossification: is alkaline phospahatase a useful early indikator of recurrence.  Orthopädische Praxis. 2000;  36 8-11
    PubMedGoogle Scholar

Korrespondenzadresse

Dr. med. M. Akbar

Stiftung Orthopädische Universitätsklinik Heidelberg

Schlierbacher Landstrasse 200A

69118 Heidelberg

Email: michael.akbar@ok.uni-heidelberg.de

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