Document Detail


Resection of heterotopic ossification in patients with spinal cord injuries.
MedLine Citation:
PMID:  2495875     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Nineteen spinal cord injury (SCI) patients were treated with resection of heterotopic ossification (HO) in 24 hips. The average follow-up period after surgery was 6.1 years. The mean time to surgery after injury was 50.6 months. The indication for surgery in all patients was improvement in hip motion to allow sitting. The average preoperative motion in flexion and extension was 11.5 degrees. The average intraoperative motion was 82.7 degrees. The average postoperative motion at the follow-up evaluation was 35.2 degrees. Fourteen of 19 patients (74%) had sufficient motion at the follow-up evaluation for sitting. Unlimited sitting tolerance was achieved in seven patients (37%), and seven patients (37%) had improved sitting posture with some time limitations. The average arc of motion in those patients able to sit at the follow-up evaluation was 41.5 degrees. Normal bone scans, alkaline phosphatase levels, and the mature roentgenographic appearance of HO were unreliable predictors of recurrence. The preoperative range of motion was the best predictor of improved postoperative range of motion since patients with retained motion did better than those with severe ankylosis. All six hips with severe recurrence had 0 degree of preoperative motion. The average degree of preoperative motion for all remaining hips was 15.3 degrees. The best predictor of recurrence was the roentgenographic grade of HO. Nineteen of 22 hips (86%) with a mild to severe recurrence had large amounts of bone preoperatively (Grades 3-5). Complications excluding recurrence occurred in 19 of 24 hips (79%) and included superficial wound infections in nine of 24 hips (38%) and deep persistent infections (osteomyelitis) in eight of 24 hips (33%).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
D E Garland; J F Orwin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  -     ISSN:  0009-921X     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  1989 May 
Date Detail:
Created Date:  1989-05-31     Completed Date:  1989-05-31     Revised Date:  2005-03-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  169-76     Citation Subset:  AIM; IM    
Affiliation:
Spinal Cord Injury Service, Rancho Los Amigos Medical Center, Downey, California 90242.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Hip Joint* / physiology,  radiography
Humans
Male
Movement
Ossification, Heterotopic / etiology,  surgery*
Postoperative Complications / etiology
Prognosis
Recurrence
Spinal Cord Injuries / complications*
Surgical Wound Infection / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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