RESEARCH PROGRESS OF HETEROTOPIC OSSIFICATION OF ELBOW JOINT AFTER TRAUMA_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HEShukun ,  HUANGFuguo

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China;

Corresponding?author：

HUANGFuguo, Email: huang-f-g@163.com

Keywords：

Elbow joint; Heterotopic ossification; Trauma

DOI：

10.7507/1002-1892.20150166

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the research progress of heterotopic ossification of the elbow joint after trauma. Methods The recent domestic and foreign literature concerning heterotopic ossification of the elbow joint after trauma was analysed and summarized. Results The mechanism of heterotopic ossification of the elbow joint after trauma is mainly related to bone morphogenetic protein signal transduction disorder. Now there are many treatments of heterotopic ossification, including non-surgical treatment, prevention, and surgical treatment. Non-surgical treatment and prevention mainly aim at patients who have no elbow heterotopic ossification or who have mild limited elbow motion because of elbow heterotopic ossification after trauma, including drug therapy, radiation therapy, Chinese medicine therapy, and rehabilitation treatment. For patients with invalid non-surgical treatment, choosing surgical treatment is a must. Surgical treatment includes surgical resection, arthroscopic resection, and joint replacement, priority should be given first to surgical resection. Conclusion Heterotopic ossification of the elbow joint is common and there is not a recognized standard treatment, comprehensive use of non-surgical treatment and surgical treatment is the future direction.

Citation： HEShukun, HUANGFuguo. RESEARCH PROGRESS OF HETEROTOPIC OSSIFICATION OF ELBOW JOINT AFTER TRAUMA. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(6): 777-782. doi: 10.7507/1002-1892.20150166 Copy

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2.	Keschner MT, Paksima N. The stiff elbow. Bull NYU Hosp Jt Dis, 2007, 65(1):24-28.
3.	Tannous O, Stall AC, Griffith C, et al. Heterotopic bone formation about the hip undergoes endochondral ossification:a rabbit model. Clin Orthop Relat Res, 2013, 471(5):1584-1592.
4.	Isaacson BM, Brown AA, Brunker LB, et al. Clarifying the structure and bone mineral content of heterotopic ossification. J Surg Res, 2011, 167(2):e163-170.
5.	Kaplan FS, Glaser DL, Hebela N, et al. Heterotopic ossification. J Am Acad Orthop Surg, 2004, 12(2):116-125.
6.	Wozney JM. The bone morphogenetic protein family:multifunctional cellular regulators in the embryo and adult. Eur J Oral Sci, 1998, 106 Suppl 1:160-166.
7.	Shore EM, Xu M, Feldman GJ, et al. A recurrent mutation in the BMP type I receptor ACVR1 causes inherited and sporadic fibrodysplasia ossificans progressive. Nat Genet, 2006, 38(5):525-527.
8.	Chauveau C, Devedjian JC, Blary MC, et al. Gene expression in human osteoblastic cells from normal and heterotopic ossification. Exp Mol Pathol, 2004, 76(1):37-43.
9.	Rodenberg E, Azhdarinia A, Lazard ZW, et al. Matrix metalloproteinase-9 is a diagnostic marker of heterotopic ossification in a murine model. Tissue Eng Part A, 2011, 17(19-20):2487-2496.
10.	Lounev VY, Ramachandran R, Wosczyna MN, et al. Identification of progenitor cells that contribute to heterotopic skeletogenesis. J Bone Joint Surg (Am), 2009, 91(3):652-663.
11.	Hannallah D, Peng H, Young B, et al. Retroviral delivery of Noggin inhibits the formation of heterotopic ossification induced by BMP-4, demineralized bone matrix, and trauma in an animal model. J Bone Joint Surg (Am), 2004, 86-A(1):80-91.
12.	Potter BK, Forsberg JA, Davis TA, et al. Heterotopic ossification following combat-related trauma. J Bone Joint Surg (Am), 2010, 92 Suppl 2:74-89.
13.	Salisbury E, Rodenberg E, Sonnet C, et al. Sensory nerve induced inflammation contributes to heterotopic ossification. J Cell Biochem, 2011, 112(10):2748-2758.
14.	Evans KN, Forsberg JA, Potter BK, et al. Inflammatory cytokine and chemokine expression is associated with heterotopic ossification in high-energy penetrating war injuries. J Orthop Trauma, 2012, 26(11):e204-e213.
15.	Forsberg JA, Potter BK, Polfer EM, et al. Do inflammatory markers portend heterotopic ossification and wound failure in combat wounds? Clin Orthop Relat Res, 2014, 472(9):2845-2854.
16.	Macfarlane RJ, Ng BH, Gamie Z, et al. Pharmacological treatment of heterotopic ossification following hip and acetabular surgery. Expert Opin Pharmacother, 2008, 9(5):767-786.
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20.	Fransen M, Neal B. Non-steroidal anti-inflammatory drugs for preventing heterotopic bone formation after hip arthroplasty. Cochrane Database Syst Rev, 2004, (3):CD001160.
21.	Sagi HC, Jordan CJ, Barei DP, et al. Indomethacin prophylaxis for heterotopic ossification after acetabular fracture surgery increases the risk for nonunion of the posterior wall. J Orthop Trauma, 2014, 28(7):377-383.
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29.	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 (Br), 1981, 63(2):201-208.
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34.	Strauss JB, Wysocki RW, Shah A, et al. Radiation therapy for heterotopic ossification prophylaxis afer high-risk elbow surgery. Am J Orthop (Belle Mead NJ), 2011, 40(8):400-405.
35.	Sell S, Willms R, Jany R, et al. The suppression of heterotopic ossifications:radiation versus NSAID therapy-a prospective study. J Arthroplasty, 1998, 13(8):854-859.
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38.	Sheybani A, TenNapel MJ, Lack WD, et al. Risk of radiation-induced malignancy with heterotopic ossification prophylaxis:a case-control analysis. Int J Radiat Oncol Biol Phys, 2014, 89(3):584-589.
39.	Burnet NG, Nasr P, Yip G, et al. Prophylactic radiotherapy against heterotopic ossification following internal fixation of acetabular fractures:a comparative estimate of risk. Br J Radiol, 2014, 87(1042):20140398.
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48.	Feranec M, Hart R, Kozák T. Hinged external fixation in orthopaedic and trauma surgery of the elbow. Acta Chir Orthop Traumatol Cech, 2013, 80(6):391-395.
49.	Mohan K. Myositis ossificans traumatica of the elbow. Int Surg, 1972, 57(6):475-478.
50.	Shehab D, Elgazzar AH, Collier BD. Heterotopic ossification. J Nucl Med, 2002, 43(3):346-353.
51.	Garland DE. A clinical perspective on common forms of acquired heterotopic ossification. Clin Orthop Relat Res, 1991, (263):13-29.
52.	Wada T, Ishii S, Usui M, et al. The medial approach for operative release of post-traumatic contracture of the elbow. J Bone Joint Surg (Br), 2000, 82(1):68-73.
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58.	Lindenhovius AL, Linzel DS, Doornberg JN, et al. Comparison of elbow contracture release in elbows with and without heterotopic ossification restricting motion. J Shoulder Elbow Surg, 2007, 16(5):621-625.
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60.	Brouwer KM, Lindenhovius AL, de Witte PB, et al. Resection of heterotopic ossification of the elbow:a comparison of ankylosis and partial restriction. J Hand Surg (Am), 2010, 35(7):1115-1119.
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1. Thompson HC 3rd, Garcia A. Myositis ossificans:aftermath of elbow injuries. Clin Orthop Relat Res, 1967, (50):129-134.
2. Keschner MT, Paksima N. The stiff elbow. Bull NYU Hosp Jt Dis, 2007, 65(1):24-28.
3. Tannous O, Stall AC, Griffith C, et al. Heterotopic bone formation about the hip undergoes endochondral ossification:a rabbit model. Clin Orthop Relat Res, 2013, 471(5):1584-1592.
4. Isaacson BM, Brown AA, Brunker LB, et al. Clarifying the structure and bone mineral content of heterotopic ossification. J Surg Res, 2011, 167(2):e163-170.
5. Kaplan FS, Glaser DL, Hebela N, et al. Heterotopic ossification. J Am Acad Orthop Surg, 2004, 12(2):116-125.
6. Wozney JM. The bone morphogenetic protein family:multifunctional cellular regulators in the embryo and adult. Eur J Oral Sci, 1998, 106 Suppl 1:160-166.
7. Shore EM, Xu M, Feldman GJ, et al. A recurrent mutation in the BMP type I receptor ACVR1 causes inherited and sporadic fibrodysplasia ossificans progressive. Nat Genet, 2006, 38(5):525-527.
8. Chauveau C, Devedjian JC, Blary MC, et al. Gene expression in human osteoblastic cells from normal and heterotopic ossification. Exp Mol Pathol, 2004, 76(1):37-43.
9. Rodenberg E, Azhdarinia A, Lazard ZW, et al. Matrix metalloproteinase-9 is a diagnostic marker of heterotopic ossification in a murine model. Tissue Eng Part A, 2011, 17(19-20):2487-2496.
10. Lounev VY, Ramachandran R, Wosczyna MN, et al. Identification of progenitor cells that contribute to heterotopic skeletogenesis. J Bone Joint Surg (Am), 2009, 91(3):652-663.
11. Hannallah D, Peng H, Young B, et al. Retroviral delivery of Noggin inhibits the formation of heterotopic ossification induced by BMP-4, demineralized bone matrix, and trauma in an animal model. J Bone Joint Surg (Am), 2004, 86-A(1):80-91.
12. Potter BK, Forsberg JA, Davis TA, et al. Heterotopic ossification following combat-related trauma. J Bone Joint Surg (Am), 2010, 92 Suppl 2:74-89.
13. Salisbury E, Rodenberg E, Sonnet C, et al. Sensory nerve induced inflammation contributes to heterotopic ossification. J Cell Biochem, 2011, 112(10):2748-2758.
14. Evans KN, Forsberg JA, Potter BK, et al. Inflammatory cytokine and chemokine expression is associated with heterotopic ossification in high-energy penetrating war injuries. J Orthop Trauma, 2012, 26(11):e204-e213.
15. Forsberg JA, Potter BK, Polfer EM, et al. Do inflammatory markers portend heterotopic ossification and wound failure in combat wounds? Clin Orthop Relat Res, 2014, 472(9):2845-2854.
16. Macfarlane RJ, Ng BH, Gamie Z, et al. Pharmacological treatment of heterotopic ossification following hip and acetabular surgery. Expert Opin Pharmacother, 2008, 9(5):767-786.
17. Shimono K, Tung WE, Macolino C, et al. Potent inhibition of heterotopic ossification by nuclear retinoic acid receptor-γ agonists. Nat Med, 2011, 17(4):454-460.
18. Kaplan FS, Shore EM. Derailing heterotopic ossification and RARing to go. Nat Med, 2011, 17(4):420-421.
19. Zimmermann SM, Würgler-Hauri CC, Wanner GA, et al. Echinomycin in the prevention of heterotopic ossification-an experimental antibiotic agent shows promising results in a murine model. Injury, 2013, 44(4):570-575.
20. Fransen M, Neal B. Non-steroidal anti-inflammatory drugs for preventing heterotopic bone formation after hip arthroplasty. Cochrane Database Syst Rev, 2004, (3):CD001160.
21. Sagi HC, Jordan CJ, Barei DP, et al. Indomethacin prophylaxis for heterotopic ossification after acetabular fracture surgery increases the risk for nonunion of the posterior wall. J Orthop Trauma, 2014, 28(7):377-383.
22. Haran M, Bhuta T, Lee BS. Pharmacological interventions for treating acute heterotopic ossification. Cochrane Database Syst Rev, 2004, (4):CD003321.
23. Vasileiadis GI, Sakellariou VI, Kelekis A, et al. Prevention of heterotopic ossification in cases of hypertrophic osteoarthritis submitted to total hip arthroplasty. Etidronate or Indomethacin? J Musculoskelet Neuronal Interact, 2010, 10(2):159-165.
24. Mamdani M, Rochon PA, Juurlink DN, et al. Observational study of upper gastrointestinal haemorrhage in elderly patients given selective cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs. BMJ, 2002, 325(7365):624.
25. Matsumura J. Considerations in the use of COX-2 inhibitors in spinal fusion surgery. Anesth Analg, 2001, 93(3):803-804.
26. Lavernia CJ, Contreras JS, Villa JM, et al. Celecoxib and heterotopic bone formation after total hip arthroplasty. J Arthroplasty, 2014, 29(2):390-392.
27. Tsailas PG, Babis GC, Nikolopoulos K, et al. The effectiveness of two COX-2 inhibitors in the prophylaxis against heterotopic new bone formation:an experimental study in rabbits. J Surg Res, 2009, 151(1):108-114.
28. Pavlou G, Kyrkos M, Tsialogiannis E, et al. Pharmacological treatment of heterotopic ossification following hip surgery:an update. Expert Opin Pharmacother, 2012, 13(5):619-622.
29. 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 (Br), 1981, 63(2):201-208.
30. Balboni TA, Gobezie R, Mamon HJ. Heterotopic ossification:pathophysiology, clinical features, and the role of radiotherapy for prophylaxis. Int J Radiat Oncol Biol Phys, 2006, 65(5):1289-1299.
31. Mishra MV, Austin L, Parvizi J, et al. Safety and efficacy of radiation therapy as secondary prophylaxis for heterotopic ossification of non-hip joints. J Med Imaging Radiat Oncol, 2011, 55(3):333-336.
32. Nasr E, Nehme R, Ghanem I, et al. Role of radiotherapy in heterotopic ossification. Cancer Radiother, 2009, 13(1):42-46.
33. Heyd R, Buhleier T, Zamboglou N. Radiation therapy for prevention of heterotopic ossification about the elbow. Strahlenther Onkol, 2009, 185(8):506-511.
34. Strauss JB, Wysocki RW, Shah A, et al. Radiation therapy for heterotopic ossification prophylaxis afer high-risk elbow surgery. Am J Orthop (Belle Mead NJ), 2011, 40(8):400-405.
35. Sell S, Willms R, Jany R, et al. The suppression of heterotopic ossifications:radiation versus NSAID therapy-a prospective study. J Arthroplasty, 1998, 13(8):854-859.
36. Hamid N, Ashraf N, Bosse MJ, et al. Radiation therapy for heterotopic ossification prophylaxis acutely after elbow trauma:a prospective randomized study. J Bone Joint Surg (Am), 2010, 92(11):2032-2038.
37. Ploumis A, Belbasis L, Ntzani E, et al. Radiotherapy for prevention of heterotopic ossification of the elbow:a systematic review of the literature. J Shoulder Elbow Surg, 2013, 22(11):1580-1588.
38. Sheybani A, TenNapel MJ, Lack WD, et al. Risk of radiation-induced malignancy with heterotopic ossification prophylaxis:a case-control analysis. Int J Radiat Oncol Biol Phys, 2014, 89(3):584-589.
39. Burnet NG, Nasr P, Yip G, et al. Prophylactic radiotherapy against heterotopic ossification following internal fixation of acetabular fractures:a comparative estimate of risk. Br J Radiol, 2014, 87(1042):20140398.
40. 王雪冰, 蔣擁軍, 郭建峰, 等. 平樂郭氏榮肌揉筋法治療創傷后肘關節功能障礙. 中國康復, 2010, 25(5):364-365.
41. 胡德新, 朱博, 鄭琦, 等. 二草二皮湯外用加手法按摩治療創傷性肘關節僵硬伴異位骨化療效觀察. 浙江中西醫結合雜志, 2014, 24(9):799-801.
42. 夏厚綱, 祝永卿, 楊清遠, 等. 中西醫結合治療創傷性肘關節骨化性肌炎27例. 實用中醫內科雜志, 2011, 25(10):63-64.
43. 鄭偉平. 中西醫結合治療肘關節創傷性骨化性肌炎. 黑龍江中醫藥, 2000, (1):36.
44. 張心堅. 桑醋煎治療肘關節創傷性骨化肌炎23例. 江蘇中醫, 2000, 21(12):35.
45. 徐義勇, 賈維東. 中西醫結合治療肘關節骨化性肌炎18例分析. 中醫藥學刊, 2003, 21(6):989.
46. 陳亞平, 楊延硯, 趙晨, 等. 合并異位骨化的關節功能康復治療. 中國康復醫學雜志, 2007, 22(12):1081-1083.
47. Chen NC, Julka A. Hinged external fixation of the elbow. Hand Clin, 2010, 26(3):423-433, vii.
48. Feranec M, Hart R, Kozák T. Hinged external fixation in orthopaedic and trauma surgery of the elbow. Acta Chir Orthop Traumatol Cech, 2013, 80(6):391-395.
49. Mohan K. Myositis ossificans traumatica of the elbow. Int Surg, 1972, 57(6):475-478.
50. Shehab D, Elgazzar AH, Collier BD. Heterotopic ossification. J Nucl Med, 2002, 43(3):346-353.
51. Garland DE. A clinical perspective on common forms of acquired heterotopic ossification. Clin Orthop Relat Res, 1991, (263):13-29.
52. Wada T, Ishii S, Usui M, et al. The medial approach for operative release of post-traumatic contracture of the elbow. J Bone Joint Surg (Br), 2000, 82(1):68-73.
53. Brinsden MD, Carr AJ, Rees JL. Post-traumatic flexion contractures of the elbow:Operative treatment via the limited lateral approach. J Orthop Surg Res, 2008, 3:39.
54. Schorn D, Steinbeck J. Results of open arthrolysis for extrinsic elbow stiffness via radial access. Indications and limits of the procedure. Orthopade, 2011, 40(4):303-306.
55. Aldridge JM 3rd, Atkins TA, Gunneson EE, et al. Anterior release of the elbow for extension loss. J Bone Joint Surg (Am), 2004, 86-A(9):1955-1960.
56. Hart R, Jane?ek M, Kozák T, et al. Posterior extensile approach to release a post-traumatic stiffness of the elbow. Acta Chir Orthop Traumatol Cech, 2011, 78(2):114-119.
57. Forthman CL, Jupiter JB. Surgical approach to the posttraumatic stiff elbow. Tech Shoulder Elbow Surg, 2004, 5(4):219-230.
58. Lindenhovius AL, Linzel DS, Doornberg JN, et al. Comparison of elbow contracture release in elbows with and without heterotopic ossification restricting motion. J Shoulder Elbow Surg, 2007, 16(5):621-625.
59. Park MJ, Chang MJ, Lee YB, et al. Surgical release for posttraumatic loss of elbow flexion. J Bone Joint Surg (Am), 2010, 92(16):2692-2699.
60. Brouwer KM, Lindenhovius AL, de Witte PB, et al. Resection of heterotopic ossification of the elbow:a comparison of ankylosis and partial restriction. J Hand Surg (Am), 2010, 35(7):1115-1119.
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