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The Journal of the American Osteopathic... Sep 2018
Topics: Female; Humans; Middle Aged; Ossification, Heterotopic; Temporal Bone; Tomography, X-Ray Computed
PubMed: 30335876
DOI: 10.7556/jaoa.2018.141 -
Stem Cell Research & Therapy Dec 2022Heterotopic ossification (HO) is the formation of bone in non-osseous tissues, such as skeletal muscles. The HO could have a genetic or a non-genetic (acquired)... (Review)
Review
Heterotopic ossification (HO) is the formation of bone in non-osseous tissues, such as skeletal muscles. The HO could have a genetic or a non-genetic (acquired) background, that is, it could be caused by musculoskeletal trauma, such as burns, fractures, joint arthroplasty (traumatic HO), or cerebral or spinal insult (neurogenetic HO). HO formation is caused by the differentiation of stem or progenitor cells induced by local or systemic imbalances. The main factors described so far in HO induction are TGFβ1, BMPs, activin A, oncostatin M, substance P, neurotrophin-3, and WNT. In addition, dysregulation of noncoding RNAs, such as microRNA or long noncoding RNA, homeostasis may play an important role in the development of HO. For example, decreased expression of miRNA-630, which is responsible for the endothelial-mesenchymal transition, was observed in HO patients. The reduced level of miRNA-421 in patients with humeral fracture was shown to be associated with overexpression of BMP2 and a higher rate of HO occurrence. Down-regulation of miRNA-203 increased the expression of runt-related transcription factor 2 (RUNX2), a crucial regulator of osteoblast differentiation. Thus, understanding the various functions of noncoding RNAs can reveal potential targets for the prevention or treatment of HO.
Topics: Humans; MicroRNAs; RNA, Long Noncoding; Ossification, Heterotopic; Osteogenesis; Cell Differentiation
PubMed: 36522666
DOI: 10.1186/s13287-022-03213-3 -
Journal of Orthopaedic Trauma Dec 2012Heterotopic ossification (HO) can be defined as the pathologic formation of bone in extraskeletal tissues. There has been a substantial amount of recent research on the... (Review)
Review
Heterotopic ossification (HO) can be defined as the pathologic formation of bone in extraskeletal tissues. There has been a substantial amount of recent research on the pathophysiology, prophylaxis, and treatment of HO and traumatic conditions associated with the development of HO. This research has advanced our understanding of this disease and helped to clarify evidence-based approaches to both the prophylaxis and treatment of HO. This article reviews the literature on these topics with a focus on their application in orthopaedic trauma.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Humans; Models, Biological; Ossification, Heterotopic; Osteotomy; Radiotherapy, Conformal; Wounds and Injuries
PubMed: 23010648
DOI: 10.1097/BOT.0b013e3182724624 -
Orthopaedics & Traumatology, Surgery &... Feb 2018Neurogenic heterotopic ossification of the hip is secondary to neurologic lesions such as cranial trauma, stroke, medullary injury or cerebral anoxia. We shall not deal... (Review)
Review
Neurogenic heterotopic ossification of the hip is secondary to neurologic lesions such as cranial trauma, stroke, medullary injury or cerebral anoxia. We shall not deal here with the other etiologies of heterotopic ossification. There are numerous locations within the hip, depending on etiology and relations with adjacent neurovascular structures are sometimes close. Preoperative work-up should include contrast-enhanced CT; scintigraphy is non-contributive. Indications for surgery are decided in a multidisciplinary team meeting, with a contract laying out expected functional gain. It is this contract that determines the extent of resection, without seeking complete resection, which would incur an increased risk of complications. The surgical approach and resection strategy depend on lesion location and any resulting neurovascular compression. The most common complications are infection and postoperative hematoma. No adjuvant treatments have demonstrated efficacy against recurrence.
Topics: Craniocerebral Trauma; Hip; Humans; Hypoxia, Brain; Ossification, Heterotopic; Stroke
PubMed: 29174871
DOI: 10.1016/j.otsr.2017.04.015 -
Journal of Biomedicine & Biotechnology 2011Heterotopic ossification (HO) is the formation of marrow-containing bone outside of the normal skeleton. Acquired HO following traumatic events is a common and costly... (Review)
Review
Heterotopic ossification (HO) is the formation of marrow-containing bone outside of the normal skeleton. Acquired HO following traumatic events is a common and costly clinical complication. In contrast, hereditary HO is rarer, progressive, and life-threatening. Substantial effort has been directed towards understanding the mechanisms underlying HO and finding efficient treatments. However, one crucial limiting factor has been the lack of relevant animal models. This article reviews the major currently available animal models, summarizes some of the insights gained from these studies, and discusses the potential future challenges and directions in HO research.
Topics: Animals; Disease Models, Animal; Genetic Diseases, Inborn; Ossification, Heterotopic
PubMed: 20981294
DOI: 10.1155/2011/309287 -
Orthopaedic Surgery May 2015Thoracic ossification of the ligamentum flavum (TOLF) is the most common cause for thoracic spinal stenosis. TOLF is usually complicated by thoracic disc herniation,... (Review)
Review
Thoracic ossification of the ligamentum flavum (TOLF) is the most common cause for thoracic spinal stenosis. TOLF is usually complicated by thoracic disc herniation, ossification of the posterior longitudinal ligament and degenerative spinal diseases such as cervical spondylosis and lumbar spinal stenosis, and the ossification also usually has a discontinuous or continuous multi-segment distribution. The resultant superposition of several symptoms makes the clinical manifestations complex. Currently, the diagnosis of TOLF depends mainly on the patient's symptoms, physical examination and thoracic CT and MRI examinations. Identification of the location of TOLF depends more on the doctor's subjective judgement. Diagnostic problems are related to the specific region and level of surgical decompression: if the extent of decompression is insufficient, the treatment is inadequate, resulting in residual symptoms. Obversely, unnecessary trauma and a various complications will occur if the decompression is too extensive. Hence, the clinical features and process of diagnosis, especially the means of identifying the location, still require further improvement. It is necessary to establish a simple and accurate means of identifying the segment of TOLF that is responsible for the neurologic deficit: a number of spinal surgeons have been working hard on this. This article will provided an overview of the clinical features of TOLF and the related problems of clinical identification of the location of the segment causing the neurological deficit. The relationship between the imaging manifestations and clinical characteristics still need to be explored with the aim of establishing a simple and precise method for determining precisely whether TOLF is related to spinal cord injury or not, thus reducing surgical trauma and achieving an optimal prognosis.
Topics: Humans; Ligamentum Flavum; Ossification, Heterotopic; Spinal Stenosis; Thoracic Vertebrae
PubMed: 26033987
DOI: 10.1111/os.12165 -
Bulletin of the NYU Hospital For Joint... 2007Etiologies of elbow contractures can be classified into intrinsic versus extrinsic causes. Posttraumatic elbow stiffness is the most common intrinsic cause and HO... (Review)
Review
Etiologies of elbow contractures can be classified into intrinsic versus extrinsic causes. Posttraumatic elbow stiffness is the most common intrinsic cause and HO formation is the most common extrinsic cause of elbow contractures. Patients who sustain significant elbow trauma and have one or more risk factors for HO formation should be given prophylaxis against HO formation in the form of either indomethacin or radiation therapy. Early excision of HO has been shown to be safe and effective. Nonoperative measures are most effective if used within 6 months of contracture onset. These measures include physical therapy and an aggressive splinting program. If nonoperative measures are unsuccessful and the patient has functionally limiting elbow ROM, then surgical intervention should be considered. Careful preoperative assessment of the ulnar nerve is mandatory, as it may need to be transposed. Satisfactory results have been reported with arthroscopic elbow contracture releases. However, this procedure is technically challenging, with the potential for serious neurovascular complications. Satisfactory results have been published for open procedures as well. The direction of the greatest limitation of motion, the presence of ulnar nerve dysfunction, and the location of osteophytes all help to dictate which surgical approach should be selected.
Topics: Arthroscopy; Collateral Ligaments; Contracture; Elbow Joint; Humans; Ossification, Heterotopic; Range of Motion, Articular; Risk Factors
PubMed: 17539758
DOI: No ID Found -
Journal of the American Veterinary... May 2016
Topics: Animals; Female; Horse Diseases; Horses; Nasal Polyps; Ossification, Heterotopic
PubMed: 27135668
DOI: 10.2460/javma.248.10.1131 -
Journal of the American Veterinary... Nov 2018
Topics: Animals; Bone Diseases, Metabolic; Dog Diseases; Dogs; Ossification, Heterotopic; Skin Diseases, Genetic
PubMed: 30311525
DOI: 10.2460/javma.253.9.1125 -
Current Osteoporosis Reports Jun 2011Heterotopic ossification is a pathologic condition in which bone tissue is formed outside of the skeleton, within soft tissues of the body. The extraskeletal bone that... (Review)
Review
Heterotopic ossification is a pathologic condition in which bone tissue is formed outside of the skeleton, within soft tissues of the body. The extraskeletal bone that forms in these disorders is normal; the cellular mechanisms that direct cell fate decisions are dysregulated. Patients with fibrodysplasia ossificans progressiva (FOP), a rare human genetic disorder of extensive and progressive heterotopic ossification, have malformations of normal skeletal elements, identifying the causative gene mutation and its relevant signaling pathways as key regulators of skeletal development and of cell fate decisions by adult stem cells. The discovery that mildly activating mutations in ACVR1/ALK2, a bone morphogenetic protein (BMP) type I receptor, is the cause of FOP has provided opportunities to identify previously unknown functions for this receptor and for BMP signaling and to develop new diagnostic and therapeutic strategies for FOP and other more common forms of heterotopic ossification, as well as tissue engineering applications.
Topics: Activin Receptors, Type I; Humans; Mutation; Myositis Ossificans; Ossification, Heterotopic; Signal Transduction
PubMed: 21340697
DOI: 10.1007/s11914-011-0046-3