EARLY SURGERY IN RARE KNEE HETEROTOPIC OSSIFICATION LEADS TO SUCCESSFUL FUNCTIONAL OUTCOME: A CASE REPORT

JOURNAL OF REHABILITATION MEDICINE, 2025 · DOI: 10.2340/jrm-cc.v8.41323 · Published: January 3, 2025

Critical Care Orthopedics Rehabilitation

Simple Explanation

Heterotopic ossification is the formation of bone in soft tissues, typically around joints like hip, knee and shoulder, causing significant pain and loss of function in the affected limb. Generally, surgical resection of the excess bone is recommended once the heterotopic ossification is fully matured, which may take at least 12 months. This case demonstrates that early surgical intervention for heterotopic ossification can lead to good clinical and functional outcomes.

Study Duration

Not specified

Participants

One young woman

Evidence Level

Level 4: Case Report

Key Findings

1
Early surgical resection of heterotopic ossification (HO) in the knee, performed just 4 months after symptom onset, resulted in a good clinical and functional outcome for a young woman.
2
Post-surgery, the patient regained pain-free walking and full range of motion in her knees after an intensive rehabilitation program.
3
The case suggests that early intervention can prevent secondary complications and improve patient outcomes, even if the ectopic bone has not fully matured.

Research Summary

This case report describes a young woman who developed severe bilateral heterotopic ossification (HO) on the anteromedial sides of her knees after an intensive care unit (ICU) stay following complications from a pregnancy-related infection. Due to the failure of initial conservative therapy, the heterotopic ossification was resected early, 4 months after onset of first symptoms. Following an intensive rehabilitation program, a normal, pain-free gait and full range of motion of both knees were achieved 9 months after surgery. The case highlights the potential benefits of early surgical intervention for HO in the knee, even before the typically recommended 12-month maturation period, leading to improved functional outcomes and prevention of secondary complications.

Practical Implications

Early Surgical Intervention

Consider early surgical resection of heterotopic ossification (HO) in the knee, even before the traditionally recommended 12-month maturation period, especially when conservative treatments fail.

Multidisciplinary Approach

Employ a multidisciplinary approach involving orthopedic surgery, physical therapy, and pain management for optimal outcomes in patients with HO.

ICU Monitoring

Be vigilant for the development of HO in ICU patients, particularly those with prolonged immobilization, inflammatory conditions, or respiratory distress, and consider early diagnostic imaging if symptoms arise.

Study Limitations

1
Single case report limits generalizability
2
Lack of a control group
3
The surgical excision of the calcifications was incomplete and residual bone formations were observed on post-operative radiological imagery

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