The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform
Jongkeun Seon - One of the best experts on this subject based on the ideXlab platform.
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Heterotopic Ossification after primary total ankle arthroplasty
Journal of Bone and Joint Surgery American Volume, 2011Co-Authors: Jukwon Park, Eunkyoo Song, Taekrim Yoon, Jongkeun SeonAbstract:Background: Heterotopic Ossification following lower-limb joint arthroplasty is a challenging clinical problem. No comprehensive study has been conducted on Heterotopic Ossification after total ankle arthroplasty, to our knowledge. The purpose of this study was to evaluate the prevalence and location of Heterotopic Ossification after primary total ankle arthroplasty, predisposing factors, and effects on clinical outcomes, and to develop a method of classification. Methods: Eighty ankles in eighty patients with a primary total ankle arthroplasty were followed for a mean (and standard deviation) of 31.9 ± 11.3 months (range, twenty-four to sixty-five months). The prevalence and location of Heterotopic Ossification, predisposing factors, and outcomes were analyzed, and a method of classification was developed. Results: Twenty (25%) of the eighty ankles demonstrated postoperative Heterotopic Ossification, with the majority of the cases in the posterior aspect of the ankle. The Heterotopic Ossification was Class I in four cases (20%); Class II, in five (25%); Class III, in four (20%); and Class IV, in seven (35%). Symptomatic Heterotopic Ossification was reported in eight patients (10%), and two required surgical resection because of intractable pain. Ankles that developed Heterotopic Ossification had significantly longer operative times, less postoperative motion, and lower American Orthopaedic Foot & Ankle Society ankle-hindfoot scores at the six, twelve, and twenty-four-month follow-up examinations (p < 0.05 for all). Conclusions: This study demonstrates that the prevalence of Heterotopic Ossification following primary total ankle arthroplasty is considerable, and that Heterotopic Ossification is associated with reduced ankle motion and a poor clinical outcome at a mean of two years postoperatively. Care is needed to attempt to reduce the occurrence of Heterotopic Ossification. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.
Martin Lavigne - One of the best experts on this subject based on the ideXlab platform.
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Heterotopic Ossification after surface replacement arthroplasty and total hip arthroplasty a randomized study
Journal of Arthroplasty, 2009Co-Authors: Krishna Reddi Boddu Siva Rama, Pascalandre Vendittoli, Muthu Ganapathi, Rene Borgmann, Martin LavigneAbstract:Abstract With a randomized clinical trial, we compared the incidence and severity of Heterotopic Ossification in cohorts of patients who have undergone either surface replacement arthroplasty or total hip arthroplasty at a minimum follow-up of 1 year. Surface replacement arthroplasty group had a significantly higher rate of severe Heterotopic Ossification (Brooker grades 3-4) than the total hip arthroplasty group, 12.6% (13/103) vs 2.1% (2/97) respectively ( P = .02). Grade 4 Heterotopic Ossification was observed (4.9%, 5/103) exclusively in the surface replacement arthroplasty group. Patients with severe Heterotopic Ossification had significantly inferior functional outcome scores. Surgeons offering surface replacement must be aware of this risk and use meticulous surgical technique and consider routine prophylaxis against Heterotopic Ossification.
Jukwon Park - One of the best experts on this subject based on the ideXlab platform.
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Heterotopic Ossification after primary total ankle arthroplasty
Journal of Bone and Joint Surgery American Volume, 2011Co-Authors: Jukwon Park, Eunkyoo Song, Taekrim Yoon, Jongkeun SeonAbstract:Background: Heterotopic Ossification following lower-limb joint arthroplasty is a challenging clinical problem. No comprehensive study has been conducted on Heterotopic Ossification after total ankle arthroplasty, to our knowledge. The purpose of this study was to evaluate the prevalence and location of Heterotopic Ossification after primary total ankle arthroplasty, predisposing factors, and effects on clinical outcomes, and to develop a method of classification. Methods: Eighty ankles in eighty patients with a primary total ankle arthroplasty were followed for a mean (and standard deviation) of 31.9 ± 11.3 months (range, twenty-four to sixty-five months). The prevalence and location of Heterotopic Ossification, predisposing factors, and outcomes were analyzed, and a method of classification was developed. Results: Twenty (25%) of the eighty ankles demonstrated postoperative Heterotopic Ossification, with the majority of the cases in the posterior aspect of the ankle. The Heterotopic Ossification was Class I in four cases (20%); Class II, in five (25%); Class III, in four (20%); and Class IV, in seven (35%). Symptomatic Heterotopic Ossification was reported in eight patients (10%), and two required surgical resection because of intractable pain. Ankles that developed Heterotopic Ossification had significantly longer operative times, less postoperative motion, and lower American Orthopaedic Foot & Ankle Society ankle-hindfoot scores at the six, twelve, and twenty-four-month follow-up examinations (p < 0.05 for all). Conclusions: This study demonstrates that the prevalence of Heterotopic Ossification following primary total ankle arthroplasty is considerable, and that Heterotopic Ossification is associated with reduced ankle motion and a poor clinical outcome at a mean of two years postoperatively. Care is needed to attempt to reduce the occurrence of Heterotopic Ossification. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.
Mary Ann E. Keenan - One of the best experts on this subject based on the ideXlab platform.
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histopathology of periarticular non hereditary Heterotopic Ossification
Bone, 2017Co-Authors: Kristin L Foley, Mary Ann E. Keenan, Nader M Hebela, Robert J PignoloAbstract:Abstract In the mature adult skeleton, new bone formation is normally restricted to regeneration of osseous tissue at sites of fracture. However, Heterotopic Ossification, or the formation of bone outside the normal skeleton, can occur within muscle, adipose, or fibrous connective tissue. Periarticular non-hereditary Heterotopic Ossification (NHHO) may occur after musculoskeletal trauma, following CNS injury, with certain arthropathies, or following injury or surgery that is often sustained in the context of age-related pathology. The histological mechanism of bone development in these forms of Heterotopic Ossification has thus far been uncharacterized. We performed a histological analysis of 90 bone specimens from 18 patients with NHHO secondary to defined precipitating conditions, including traumatic brain injury, spinal cord injury, cerebrovascular accident, trauma without neurologic injury, and total hip or knee arthroplasty. All bone specimens revealed normal endochondral osteogenesis at Heterotopic sites. We defined the order of sequence progression in NHHO lesion formation as occurring through six distinct histological stages: (1) perivascular lymphocytic infiltration, (2) lymphocytic migration into soft tissue, (3) reactive fibroproliferation, (4) neovascularity, (5) cartilage formation, and (6) endochondral bone formation. This study provides the first systematic evaluation of the predominant histopathological findings associated with multiple forms of NHHO and shows that they share a common mechanism of lesion formation.
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Radiation therapy for preventing recurrence of neurogenic Heterotopic Ossification.
Orthopedics, 2009Co-Authors: Cara A. Cipriano, Stephan G. Pill, Jeffrey Rosenstock, Mary Ann E. KeenanAbstract:: Radiation therapy is commonly used to prevent Heterotopic Ossification, and the dose-dependent effects of this treatment have been well documented in patients after total hip arthroplasty (THA). However, the efficacy and dose requirement of radiation therapy to prevent Heterotopic Ossification of nonsurgical origin have not been studied. The purpose of this retrospective case-control study was to determine the effects of prophylactic radiation therapy on severe Heterotopic Ossification recurrence, postoperative range of motion (ROM), and wound healing in patients with Heterotopic Ossification secondary to neurologic deficits. Selection was not blinded, and higher risk patients were generally assigned to the treatment group. Standard doses of radiation therapy did not adequately lower recurrence rates; in fact, there was a higher incidence of Heterotopic Ossification formation necessitating revision in the treatment group (15.0%) compared to the control group (5.1%). Moreover, patients who received radiation therapy were not more successful at maintaining intraoperative ROM over time. There was a similar incidence of delayed wound healing between groups (12.8% in the control group and 12.5% in the treatment group), and no other negative side effects or complications were observed. These results suggest that the 700 cGy dose of radiation therapy typically used for the prophylaxis of Heterotopic Ossification associated with THA does not effectively prevent the recurrence of neurogenic Heterotopic Ossification in high-risk patients. Further studies are needed to determine whether higher doses of radiation therapy will provide more effective prophylaxis for Heterotopic Ossification.
Krishna Reddi Boddu Siva Rama - One of the best experts on this subject based on the ideXlab platform.
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Heterotopic Ossification after surface replacement arthroplasty and total hip arthroplasty a randomized study
Journal of Arthroplasty, 2009Co-Authors: Krishna Reddi Boddu Siva Rama, Pascalandre Vendittoli, Muthu Ganapathi, Rene Borgmann, Martin LavigneAbstract:Abstract With a randomized clinical trial, we compared the incidence and severity of Heterotopic Ossification in cohorts of patients who have undergone either surface replacement arthroplasty or total hip arthroplasty at a minimum follow-up of 1 year. Surface replacement arthroplasty group had a significantly higher rate of severe Heterotopic Ossification (Brooker grades 3-4) than the total hip arthroplasty group, 12.6% (13/103) vs 2.1% (2/97) respectively ( P = .02). Grade 4 Heterotopic Ossification was observed (4.9%, 5/103) exclusively in the surface replacement arthroplasty group. Patients with severe Heterotopic Ossification had significantly inferior functional outcome scores. Surgeons offering surface replacement must be aware of this risk and use meticulous surgical technique and consider routine prophylaxis against Heterotopic Ossification.