Myositis ossificans following porous-ingrowth TK replacement

Clinically significant myositis ossificans of the distal thigh following virginal porous-ingrowth total knee arthroplasty has not been previously reported. Associated and potentially contributing factors in this particular case were (1) the patient's preoperative hypertrophic gonarthrosis, (2) our difficulty in regulating her postoperative sodium warfarin (Coumadin) dosages, (3) the postoperative knee manipulation, and (4) possibly, the additional surgical exposure of this patient's distal femur required to use the femur-based alignment instrumentation. Postoperative heterotopic ossification developing in the vicinity of a porous-ingrowth total knee prosthesis can have clinical significance. Treatment of this problem by a means that does not interfere with early bone ingrowth into the implant is a practical concern that warrants investigation.