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EARLY SURGERY IN RARE KNEE HETEROTOPIC OSSIFICATION LEADS TO SUCCESSFUL FUNCTIONAL OUTCOME: A CASE REPORT.
Stijn Pierreux1, Samar M Hatem1,2,3,4, Stijn Roggeman1
1Department of Physical and Rehabilitation Medicine, Universitair Ziekenhuis Brussel.
Journal of Rehabilitation Medicine. Clinical Communications
|January 13, 2025
Summary
Early surgical removal of heterotopic ossification, a bone growth complication, can restore knee function. This approach, performed sooner than typically recommended, led to a full recovery in a young patient.
Area of Science:
- Orthopedic Surgery
- Regenerative Medicine
- Medical Case Reports
Background:
- Heterotopic ossification (HO) frequently complicates joint replacement and intensive care unit stays, particularly after traumatic brain or spinal cord injuries.
- HO involves abnormal bone formation in soft tissues, often leading to joint stiffness and functional limitations.
- Current recommendations suggest surgical resection of HO only after bone maturation, typically 12 months post-onset, to prevent recurrence.
Purpose of the Study:
- To present a case of severe, early-onset heterotopic ossification in a young woman following an intensive care unit stay.
- To evaluate the efficacy of early surgical intervention for heterotopic ossification, challenging the traditional 12-month waiting period.
Main Methods:
- A case report detailing a young woman with no prior medical history who developed severe bilateral knee heterotopic ossification.
- Diagnosis confirmed via X-ray, with predisposing factors including prolonged immobilization, inflammation, and mechanical ventilation.
- Early surgical resection of HO was performed 4 months after symptom onset, followed by intensive rehabilitation.
Main Results:
- The patient experienced significant limitations in knee flexion (50°) due to severe bilateral HO.
- Following early surgical resection and rehabilitation, the patient achieved a normal, pain-free gait and full range of motion in both knees within 9 months post-surgery.
- X-ray imaging served as a straightforward diagnostic tool for assessing the extent of heterotopic ossification.
Conclusions:
- This case report supports early surgical resection of heterotopic ossification as a viable treatment option.
- Prompt intervention, even before complete bone maturation, can lead to favorable clinical and functional outcomes.
- Early HO resection may offer a better alternative to prolonged conservative management in select cases.
