Massive Hip Heterotopic Ossification in a Polytrauma Patient: A Case Report
Abstract
Background: Heterotopic ossification (HO) around the hip joint is correlated with a dramatic reduction in hip range of motion
(ROM) and quality of life (QOL).
Case Report: We report on a 45-year-old man with a massive right hip HO with intensive reduction in his right hip ROM. He
underwent surgical resection via Smith-Petersen approach by an experienced hip surgeon, as well as a vascular surgeon.
Neurovascular bundle was explored and protected. The mass was excised as much as possible. The ROM increased instantly to near
full. After surgery, we used indomethacin in order to hinder the HO relapse.
Conclusion: The surgical resection of hip HO is a feasible treatment option; however, it is challenging.
1. Zhang X, Jie S, Liu T, Zhang X. Acquired heterotopic
ossification in hips and knees following encephalitis: case
report and literature review. BMC Surg. 2014;14:74. doi:
10.1186/1471-2482-14-74. [PubMed: 25280472]. [PubMed Central:
PMC4189048].
2. Nauth A, Giles E, Potter BK, Nesti LJ, Oʼbrien FP, Bosse MJ, et al.
Heterotopic ossification in orthopaedic trauma. J Orthop
Trauma. 2012;26(12):684-8. doi: 10.1097/BOT.0b013e3182724624.
[PubMed: 23010648]. [PubMed Central: PMC3504617].
3. Parikh S, Tacy C, Gomez O, Corces A. The Treatment of
Heterotopic Ossification With a Dual Mobility Total Hip
Replacement System: A Case Report. Cureus. 2022;14(4):e23977.
doi: 10.7759/cureus.23977. [PubMed: 35547404]. [PubMed Central:
PMC9089932].
4. Xu Y, Huang M, He W, He C, Chen K, Hou J, et al. Heterotopic
Ossification: Clinical Features, Basic Researches, and
Mechanical Stimulations. Front Cell Dev Biol. 2022;10:770931.
doi: 10.3389/fcell.2022.770931. [PubMed: 35145964]. [PubMed
Central: PMC8824234].
5. Nóbrega JPG, Jordão P, Arcângelo J. Bilateral hip heterotopic
ossification with sciatic nerve compression on a paediatric
patient-An individualized surgical approach: A case report.
World J Orthop. 2022;13(8):768-74. doi: 10.5312/wjo.v13.i8.768.
[PubMed PMID: 36159619]. [PubMed Central: PMC9453277].
6. Johnson EE, Kay RM, Dorey FJ. Heterotopic ossification
prophylaxis following operative treatment of acetabular
fracture. Clin Orthop Relat Res. 1994(305):88-95. [PubMed:
8050251].
7. Kesikburun S, Omaç Ö K, Yaşar E, Hazneci B, Alaca R. Severe
heterotopic ossification in the non-affected limbs of a
hemiplegic patient with traumatic brain injury. Brain Inj.
2011;25(1):127-9. doi: 10.3109/02699052.2010.536198. [PubMed:
21142825].
8. Brumat P, Trojner T, Trebše R. Massive Heterotopic Ossification
of the Tensor Fascia Lata in a Bodybuilder Leading to Severe
Hip Dysfunction: A Case Report. JBJS Case Connect.
2020;10(3):e19.00581. doi: 10.2106/jbjs.Cc.19.00581. [PubMed:
32910620].
9. Kinoshita Y, Nakano S, Yoshioka S, Nakamura M, Goto T,
Hamada D, et al. A Rare Case of Extremely Severe Heterotopic
Ossification after Primary Total Hip Arthroplasty due to
Persistent Mild Periprosthetic Joint Infection. Case Rep
Orthop. 2021;2021:8849929. doi: 10.1155/2021/8849929. [PubMed:
34094609]. [PubMed Central: PMC8164530].
10. Wu XB, Yang MH, Zhu SW, Cao QY, Wu HH, Wang MY, et al.
Surgical resection of severe heterotopic ossification after open
reduction and internal fixation of acetabular fractures: a case
series of 18 patients. Injury. 2014;45(10):1604-10. doi:
10.1016/j.injury.2014.05.018. [PubMed: 24917211].
11. Shehab D, Elgazzar AH, Collier BD. Heterotopic ossification. J
Nucl Med. 2002;43(3):346-53. [PubMed: 11884494].
12. Teasell RW, Mehta S, Aubut JL, Ashe MC, Sequeira K, Macaluso S,
et al. A systematic review of the therapeutic interventions for
heterotopic ossification after spinal cord injury. Spinal Cord.
2010;48(7):512-21. doi: 10.1038/sc.2009.175. [PubMed: 20048753].
[PubMed Central: PMC3218076].
13. Buschbacher R, McKinley W, Buschbacher L, Devaney CW,
Coplin B. Warfarin in prevention of heterotopic ossification.
Am J Phys Med Rehabil. 1992;71(2):86-91. doi: 10.1097/00002060-
199204000-00005. [PubMed: 1558739].
14. Banovac K, Williams JM, Patrick LD, Haniff YM. Prevention of
heterotopic ossification after spinal cord injury with
indomethacin. Spinal Cord. 2001;39(7):370-4. doi:
10.1038/sj.sc.3101166. [PubMed: 11464310].
15. Van Kuijk AA, Geurts AC, Van Kuppevelt HJ. Neurogenic
heterotopic ossification in spinal cord injury. Spinal Cord.
2002;40(7):313-26. doi: 10.1038/sj.sc.3101309. [PubMed: 12080459]
ossification in hips and knees following encephalitis: case
report and literature review. BMC Surg. 2014;14:74. doi:
10.1186/1471-2482-14-74. [PubMed: 25280472]. [PubMed Central:
PMC4189048].
2. Nauth A, Giles E, Potter BK, Nesti LJ, Oʼbrien FP, Bosse MJ, et al.
Heterotopic ossification in orthopaedic trauma. J Orthop
Trauma. 2012;26(12):684-8. doi: 10.1097/BOT.0b013e3182724624.
[PubMed: 23010648]. [PubMed Central: PMC3504617].
3. Parikh S, Tacy C, Gomez O, Corces A. The Treatment of
Heterotopic Ossification With a Dual Mobility Total Hip
Replacement System: A Case Report. Cureus. 2022;14(4):e23977.
doi: 10.7759/cureus.23977. [PubMed: 35547404]. [PubMed Central:
PMC9089932].
4. Xu Y, Huang M, He W, He C, Chen K, Hou J, et al. Heterotopic
Ossification: Clinical Features, Basic Researches, and
Mechanical Stimulations. Front Cell Dev Biol. 2022;10:770931.
doi: 10.3389/fcell.2022.770931. [PubMed: 35145964]. [PubMed
Central: PMC8824234].
5. Nóbrega JPG, Jordão P, Arcângelo J. Bilateral hip heterotopic
ossification with sciatic nerve compression on a paediatric
patient-An individualized surgical approach: A case report.
World J Orthop. 2022;13(8):768-74. doi: 10.5312/wjo.v13.i8.768.
[PubMed PMID: 36159619]. [PubMed Central: PMC9453277].
6. Johnson EE, Kay RM, Dorey FJ. Heterotopic ossification
prophylaxis following operative treatment of acetabular
fracture. Clin Orthop Relat Res. 1994(305):88-95. [PubMed:
8050251].
7. Kesikburun S, Omaç Ö K, Yaşar E, Hazneci B, Alaca R. Severe
heterotopic ossification in the non-affected limbs of a
hemiplegic patient with traumatic brain injury. Brain Inj.
2011;25(1):127-9. doi: 10.3109/02699052.2010.536198. [PubMed:
21142825].
8. Brumat P, Trojner T, Trebše R. Massive Heterotopic Ossification
of the Tensor Fascia Lata in a Bodybuilder Leading to Severe
Hip Dysfunction: A Case Report. JBJS Case Connect.
2020;10(3):e19.00581. doi: 10.2106/jbjs.Cc.19.00581. [PubMed:
32910620].
9. Kinoshita Y, Nakano S, Yoshioka S, Nakamura M, Goto T,
Hamada D, et al. A Rare Case of Extremely Severe Heterotopic
Ossification after Primary Total Hip Arthroplasty due to
Persistent Mild Periprosthetic Joint Infection. Case Rep
Orthop. 2021;2021:8849929. doi: 10.1155/2021/8849929. [PubMed:
34094609]. [PubMed Central: PMC8164530].
10. Wu XB, Yang MH, Zhu SW, Cao QY, Wu HH, Wang MY, et al.
Surgical resection of severe heterotopic ossification after open
reduction and internal fixation of acetabular fractures: a case
series of 18 patients. Injury. 2014;45(10):1604-10. doi:
10.1016/j.injury.2014.05.018. [PubMed: 24917211].
11. Shehab D, Elgazzar AH, Collier BD. Heterotopic ossification. J
Nucl Med. 2002;43(3):346-53. [PubMed: 11884494].
12. Teasell RW, Mehta S, Aubut JL, Ashe MC, Sequeira K, Macaluso S,
et al. A systematic review of the therapeutic interventions for
heterotopic ossification after spinal cord injury. Spinal Cord.
2010;48(7):512-21. doi: 10.1038/sc.2009.175. [PubMed: 20048753].
[PubMed Central: PMC3218076].
13. Buschbacher R, McKinley W, Buschbacher L, Devaney CW,
Coplin B. Warfarin in prevention of heterotopic ossification.
Am J Phys Med Rehabil. 1992;71(2):86-91. doi: 10.1097/00002060-
199204000-00005. [PubMed: 1558739].
14. Banovac K, Williams JM, Patrick LD, Haniff YM. Prevention of
heterotopic ossification after spinal cord injury with
indomethacin. Spinal Cord. 2001;39(7):370-4. doi:
10.1038/sj.sc.3101166. [PubMed: 11464310].
15. Van Kuijk AA, Geurts AC, Van Kuppevelt HJ. Neurogenic
heterotopic ossification in spinal cord injury. Spinal Cord.
2002;40(7):313-26. doi: 10.1038/sj.sc.3101309. [PubMed: 12080459]
| Files | ||
| Issue | Vol 11 No 2 (2025) | |
| Section | Case Report | |
| Keywords | ||
| Hip; Heterotopic Ossification; Surgical Resection; Case Reports; Multiple Trauma | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Zandi R, Talebi S, Behroo F, Nodehi S, Ehsani A. Massive Hip Heterotopic Ossification in a Polytrauma Patient: A Case Report. J Orthop Spine Trauma. 2025;11(2):77-80.
