A classification method for neurogenic heterotopic ossification of the hip View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2012-04-04

AUTHORS

Andreas F. Mavrogenis, Giovanni Guerra, Eric Lodwijk Staals, Giuseppe Bianchi, Pietro Ruggieri

ABSTRACT

BackgroundExisting classifications for heterotopic ossification (HO) do not include all HO types; nor do they consider the anatomy of the involved joint or the neurological injury. Therefore, we performed this study to propose and evaluate a classification according to the location of neurogenic HO and the neurological injury.Materials and methodsWe studied the files of 24 patients/33 hips with brain or spinal cord injury and neurogenic HO of the hip treated with excision, indomethacin, and radiation therapy. We classified patients according to the Brooker classification scheme as well as ours. Four types of neurogenic HO were distinguished according to the anatomical location of HO: type 1, anterior; type 2, posterior; type 3, anteromedial; type 4, circumferential. Subtypes of each type were added based on the neurological injury: a, spinal cord; b, brain injury. Mean follow-up was 2.5 years (1–8 years).ResultsThe Brooker classification scheme was misleading—all hips were class III or IV, corresponding to ankylosis, even though only 14 hips had ankylosis. On the other hand, our classification was straightforward and easy to assign in all cases. It corresponded better to the location of the heterotopic bone, and allowed for preoperative planning of the appropriate surgical approach and evaluation of the prognosis; recurrence of neurogenic HO was significantly higher in patients with brain injury (subtype b), while blood loss was higher for patients with anteromedial (type 3) and circumferential (type 4) neurogenic HO.ConclusionsOur proposed classification may improve the management and evaluation of the prognosis for patients with neurogenic HO. More... »

PAGES

69-78

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10195-012-0193-z

DOI

http://dx.doi.org/10.1007/s10195-012-0193-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1002490550

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22476356


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