Question:I have a problem in my elbow called heterotopic ossification. I got it after I dislocated my elbow falling on the ice. By the time anyone realized I had it, it was too late to prevent it. Now we are looking at surgery. I don't want to wait too long for that. How soon can this operation be done?
Answer:Heterotopic ossification (HO) is the formation of bone fragments within the soft tissues around a joint. This condition is called myositis ossificans when it occurs in inflamed muscles.
HO appears to be directly linked to the severity of the trauma. Nerve damage or burns are especially susceptible to the formation of HO. Direct trauma to the elbow such as a dislocation and/or fracture can also lead to HO.
When a person is known to be at risk for HO, chemotherapy or low-dose radiation therapy can be used to prevent it. Non-steroidal antiinflammatory drugs such as indomethacin can also be effective preventive therapy.
But when joint contracture occurs and motion is limited, then surgery may be needed. At one time, it was thought that surgery should be delayed until no further bone growth occurred. More recent studies suggest this may not be so.
Early excision can be done without recurrence of HO. Contracture release and removal of the bone fragments can be done as early as three to six months after the injury.
You surgeon is the best one to advise you on the timing of this surgery. He or she will review your records and CT scans. Results of removing bone growth are best when only one plane of tissue is involved. When more layers are affected, the results are less predictable.Mitchell T. Keschner, MD, and Nader Paksima, DO, MPH. The Stiff Elbow. In Bulletin of the NYU Hospital for Joint Diseases. Supplement 2, 2007. Vol. 65. Pp. 24-28.
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