Skip to main content
Top
Published in: Critical Care 6/2006

01-12-2006 | Commentary

Heterotopic ossification – a long-term consequence of prolonged immobility

Authors: Sonia J Hudson, Stephen J Brett

Published in: Critical Care | Issue 6/2006

Login to get access

Abstract

Heterotopic ossification is a condition affecting an appreciable minority of critical care patients; it can have long-lasting effects on recovery and return to functional status. Ectopic bone forms in soft tissues near the large joints, causing pain, swelling, limitation of movement and ultimate disability. X-ray changes may be delayed for several weeks after the diagnosis is clinically suspected. Magnetic resonance imaging may be more sensitive for detecting early changes, yielding positive results several weeks before X-rays. However it is not clear that diagnosing the process early will influence long-term patient outcome, because no effective treatments are available.
Literature
1.
go back to reference Argyropoulou MI, Kostandi E, Kosta P, Zikou AK, Kastani D, Galiatsou E, Kitsakos A, Nakos G: Heterotopic ossification of the knee joint in intensive care unit patients: early diagnosis with magnetic resonance imaging. Crit Care 2006, 10: R152. 10.1186/cc5083PubMedCentralCrossRefPubMed Argyropoulou MI, Kostandi E, Kosta P, Zikou AK, Kastani D, Galiatsou E, Kitsakos A, Nakos G: Heterotopic ossification of the knee joint in intensive care unit patients: early diagnosis with magnetic resonance imaging. Crit Care 2006, 10: R152. 10.1186/cc5083PubMedCentralCrossRefPubMed
2.
go back to reference Cheung AM, Tansey CM, Tomlinson G, Diaz-Granados N, Matte-Martyn A, Mehta S, Mazer D, Guest CB, Stewart TE, Al-Saidi F, for the Canadian Critical Care Trials Group, et al.: Two-year outcomes, health care use, and costs of survivors of acute respiratory distress syndrome. Am J Respir Crit Care Med 2006, 174: 538-544. 10.1164/rccm.200505-693OCCrossRefPubMed Cheung AM, Tansey CM, Tomlinson G, Diaz-Granados N, Matte-Martyn A, Mehta S, Mazer D, Guest CB, Stewart TE, Al-Saidi F, for the Canadian Critical Care Trials Group, et al.: Two-year outcomes, health care use, and costs of survivors of acute respiratory distress syndrome. Am J Respir Crit Care Med 2006, 174: 538-544. 10.1164/rccm.200505-693OCCrossRefPubMed
3.
go back to reference Jones C, Skirrow P, Griffiths RD, Humphris GH, Ingleby S, Eddleston J, Waldmann C, Gager M: Rehabilitation after critical illness: a randomized, controlled trial. Crit Care Med 2003, 31: 2456-2461. 10.1097/01.CCM.0000089938.56725.33CrossRefPubMed Jones C, Skirrow P, Griffiths RD, Humphris GH, Ingleby S, Eddleston J, Waldmann C, Gager M: Rehabilitation after critical illness: a randomized, controlled trial. Crit Care Med 2003, 31: 2456-2461. 10.1097/01.CCM.0000089938.56725.33CrossRefPubMed
5.
go back to reference Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, Cooper AB, Guest CB, Mazer CD, Mehta S: One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 2003, 348: 683-693. 10.1056/NEJMoa022450CrossRefPubMed Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, Cooper AB, Guest CB, Mazer CD, Mehta S: One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 2003, 348: 683-693. 10.1056/NEJMoa022450CrossRefPubMed
6.
go back to reference Sugita A, Hashimoto J, Maeda A, Kobayashi J, Hirao M, Masuhara K, Yoneda M, Yoshikawa H: Heterotopic ossification in bilateral knee and hip joints after long-term sedation. J Bone Miner Metab 2005, 23: 329-332. 10.1007/s00774-005-0608-5CrossRefPubMed Sugita A, Hashimoto J, Maeda A, Kobayashi J, Hirao M, Masuhara K, Yoneda M, Yoshikawa H: Heterotopic ossification in bilateral knee and hip joints after long-term sedation. J Bone Miner Metab 2005, 23: 329-332. 10.1007/s00774-005-0608-5CrossRefPubMed
7.
go back to reference Pape HC, Lehmann U, van Griensven M, Gansslen A, von Glinski S, Krettek C: Heterotopic ossifications in patients after severe blunt trauma with and without head trauma: incidence and patterns of distribution. J Orthop Trauma 2001, 15: 229-237. 10.1097/00005131-200105000-00001CrossRefPubMed Pape HC, Lehmann U, van Griensven M, Gansslen A, von Glinski S, Krettek C: Heterotopic ossifications in patients after severe blunt trauma with and without head trauma: incidence and patterns of distribution. J Orthop Trauma 2001, 15: 229-237. 10.1097/00005131-200105000-00001CrossRefPubMed
8.
go back to reference Rossier AB, Bussat P, Infante F, Zender R, Courvoisier B, Muhelm G, Donath A, Vasey H, Taillard W, Lagier R, et al.: Current facts of para-osteo-arthropathy (POA). Paraplegia 1973, 11: 38-78.CrossRefPubMed Rossier AB, Bussat P, Infante F, Zender R, Courvoisier B, Muhelm G, Donath A, Vasey H, Taillard W, Lagier R, et al.: Current facts of para-osteo-arthropathy (POA). Paraplegia 1973, 11: 38-78.CrossRefPubMed
9.
go back to reference Kaplan FS, Glaser DL, Hebela N, Shore EM: Heterotopic ossification. J Am Acad Orthop Surg 2004, 12: 116-125.PubMed Kaplan FS, Glaser DL, Hebela N, Shore EM: Heterotopic ossification. J Am Acad Orthop Surg 2004, 12: 116-125.PubMed
10.
go back to reference Knelles D, Barthel T, Karrer A, Kraus U, Eulert J, Kölbl O: Prevention of heterotopic ossification after total hip replacement. A prospective randomised study using acetylsalicylic acid, indomethacin and fractional or single dose irradiation. J Bone Joint Surg 1997, 79B: 596-602. 10.1302/0301-620X.79B4.6829CrossRef Knelles D, Barthel T, Karrer A, Kraus U, Eulert J, Kölbl O: Prevention of heterotopic ossification after total hip replacement. A prospective randomised study using acetylsalicylic acid, indomethacin and fractional or single dose irradiation. J Bone Joint Surg 1997, 79B: 596-602. 10.1302/0301-620X.79B4.6829CrossRef
11.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
12.
go back to reference Schuetz P, Mueller B, Christ-Crain M, Dick W, Haas H: Aminobisphosphonates in heterotopic ossification: first experience in five consecutive cases. Spinal Cord 2005, 43: 604-610. 10.1038/sj.sc.3101761CrossRefPubMed Schuetz P, Mueller B, Christ-Crain M, Dick W, Haas H: Aminobisphosphonates in heterotopic ossification: first experience in five consecutive cases. Spinal Cord 2005, 43: 604-610. 10.1038/sj.sc.3101761CrossRefPubMed
Metadata
Title
Heterotopic ossification – a long-term consequence of prolonged immobility
Authors
Sonia J Hudson
Stephen J Brett
Publication date
01-12-2006
Publisher
BioMed Central
Published in
Critical Care / Issue 6/2006
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc5091

Other articles of this Issue 6/2006

Critical Care 6/2006 Go to the issue