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Atraumatic heterotopic ossification after pulmonary failure and prolonged mechanical ventilation: case report


Authors: Jr Kloc Ján 1;  Šteňo Boris 2;  Sr Kloc Ján 1
Authors‘ workplace: Oddelenie ortopédie, FNsP J. A. Reimana, Prešov 1;  II. ortopedicko- traumatologická klinika LF UK a UNB, Nemocnica sv. Cyrila a Metoda, Bratislava 2
Published in: Clinical Osteology 2021; 26(2): 98-102
Category:

Overview

Heterotopic ossification is well-described, often complication after musculoskeletal trauma, surgery and neurotrauma. We present a patient who developed heterotopic ossification of hip joints with bony ankylosis after prolonged artificial pulmonary ventilation because of pulmonary failure after H1N1 pneumonia. Atraumatic heterotopic ossification occurs in critically ill patients after mechanical ventilation, including patients with COVID-19 disease. We consider imobilization and artificial pulmonary ventilation as a possible causal factors of heterotopic ossification. Early diagnosis and implementation of potentional preventive and therapeutical tools, such as anti-inflammatory drugs and appropriate physiotherapy, are needed to decrease morbidity in patients with risk factors. The timing of surgical excision must be considered according to a risk of recurrence and irreversible joint damage.

Keywords:

artificial mechanical ventilation – COVID-19 – heterotopic ossification


Sources
  1. Brooker AF, Bowerman JW, Robinson RA et al. Ectopic ossification following total hip replacement. Incidence and method of classification. J Bone Joint Surg Am 1973; 55(8): 1629–1632.
  2. Garland DE. A clinical perspective on common forms of acquired heterotopic ossification. Clin Orthop 1991; (263): 13–29.
  3. Kľoc J. Neurogenic heterotopic ossification. Clinic Osteol 2020; 25(3): 128–134.
  4. Pignolo RJ, Kaplan FS. Clinical staging of fibrodysplasia ossificans progressiva (FOP). Bone 2018; 109: 111–114. Dostupné z DOI: <http:// doi: 10.1016/j.bone.2017.09.014>.
  5. Kaplan FS, Craver R, MacEwen GD et al. Progressive osseous heteroplasia: a distinct developmental disorder of heterotopic ossification. Two new case reports and follow-up of three previously reported cases. J Bone Joint Surg Am 1994; 76(3): 425–436.
  6. Cipriano CA, Pill SG, Keenan MA. Heterotopic ossification following traumatic brain injury and spinal cord injury. J Am Acad Orthop Surg 2009; 17: 689–697. Dostupné z DOI: <http://doi: 10.5435/00124635– 200911000–00003>.
  7. Halas RA, Karuppiah S. Heterotopic ossification of the hip after stroke. Curr Orthop Pract 2011; 22(2): E19–E21. Dostupné z DOI: <http://dx.doi.org/10.1097/BCO.0b013e3181ff73af>.
  8. Ebinger T, Roesch M, Kiefer H et al. Influence of etiology in heterotopic bone formation of the hip. J Trauma 2000; 4 8: 1058–1062. Dostupné z DOI: <http://doi: 10.1097/00005373–200006000–00010>.
  9. Chalmers J, Gray DH, Rush J. Observations on the induction of bone in soft tissues. J Bone Joint Surg 1975; 57(B): 36–45.
  10. Jones KB, Mollano AV, Morcuende JA et al. Bone and brain: a review of neural, hormonal, and musculoskeletal connections. Iowa Orthop J 2004; 24: 123–132.
  11. Chen D, Zhao M, Mundy GR. Bone morphogenetic proteins. Growth Factors 2004; 22(4): 233–241. Dostupné z DOI: <http://doi: 10.1080/08977190412331279890>.
  12. Christakou A, Alimatiri M, Kouvarakos A et al. Heterotopic ossification in critical ill patients: a review. Int J Physiother Res 2013; 1(4):188– 195.
  13. Clements NC jr, Camilli AE. Heterotopic ossification complicating critical illness. Chest 1993 ;104(5):1526–1528. Dostupné z DOI: <http://doi: 10.1378/chest.104.5.1526>.
  14. Davis C, Kolovich GP, Scharschmidt TJ. Atraumatic heterotopic ossification in the setting of prolonged intubation because of H1N1 influenza: a case report. Orthop Surg 2012; 4(4): 258–262. Dostupné z DOI: <http://doi: 10.1111/os.12009>.
  15. Meyer C, Haustrate MA, Nisolle JF, Deltombe T. Heterotopic ossification in COVID-19: a series of 4 cases. Ann Phys Rehabil Med 2 020; 6 3(6): 5 65–567. D ostupné z DOI: < http://doi: 1 0.1016/j.rehab.2020.09.010>.
  16. Aziz A, Choudhari R, Alexander AJ et al. Heterotopic ossification post COVID-19: Report of two cases. Radiol Case Rep 2021; 16: 404– 409. Dostupné z DOI: <http://doi: 10.1016/j.radcr.2020.12.002>.
  17. Stoira E, Elzi L, Puligheddu C et al. High prevalence of heterotopic ossification in critically ill patients with severe COVID-19. Clin Microbiol 2 021; 2 7(7): 1 049–1050. D ostupné z DOI: < http://doi: 1 0.1016/j. cmi.2020.12.037>.
  18. Brighton CT, Schaffer JL, Shapiro DB et al. Proliferation and macromolecular synthesis by rat calvarial bone cells grown in various oxygen tensions. J Bone Joint Surg Am 1991; 9: 847–854. Dostupné z DOI: <http://doi: 10.1002/jor.1100090610>.
  19. Genet F, Jourdan C, Lautridou C et al. The impact of preoperative hip heterotopic ossification extent on recurrence in patients with head and spinal cord injury: a case control study. PLoS One 2011; 6:e23129. Dostupné z DOI: <http://doi: 10.1371/journal.pone.0023129>.
  20. Denormandie P, de l’Escalopier N, Gatin L et al. Resection of neurogenic heterotopic ossification (NHO) of the hip. Orthop Traumatol Surg Res 2018; 104(1S): S121-S127. Dostupné z DOI: <http://doi: 10.1016/j. otsr.2017.04.015>.
  21. Banovac K. The effect of Etidronate on late development of heterotopic ossification after spinal cord injury. J Spinal Cord Med 2000; 23(1): 40–44. Dostupné z DOI: <http://doi: 10.1080/10790268.2000.11753507>.
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