Heterotopic ossifications: role of radiotherapy as prophylactic treatment

Background Heterotopic ossification (HO) is abnormal formation of lamellar bone in soft tissue; the most frequent causes are total hip arthroplasty and trauma. Severe cases can lead to ankilosis with important impact on quality of life. Surgery is the elective treatment, but, especially in high-risk...

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Bibliographic Details
Published in:Radiologia medica 2018-06, Vol.123 (6), p.463-468
Main Authors: Ruo Redda, Maria Grazia, De Colle, Chiara, Bianco, Lavinia, Ruggieri, Andrea, Nassisi, Daniela, Rossi, Annalisa, Gino, Eva, Airaldi, Claudia
Format: Article
Language:English
Subjects:
Biomedical materials
Diagnostic Radiology
Imaging
Interventional Radiology
Joint surgery
Medicine
Medicine & Public Health
Neuroradiology
Patients
Radiation therapy
Radiology
Radiotherapy
Risk
Surgery
Surgical implants
Toxicity
Ultrasound
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Summary:Background Heterotopic ossification (HO) is abnormal formation of lamellar bone in soft tissue; the most frequent causes are total hip arthroplasty and trauma. Severe cases can lead to ankilosis with important impact on quality of life. Surgery is the elective treatment, but, especially in high-risk patients, it is important to prevent the re-formation of HO and, in these cases, radiotherapy (RT) can play an important role. Materials and methods we retrospectively analyzed a mono-institutional casistic of 30 patients (31 sites) at high risk for HO development, treated with surgery and pre- or postoperative RT. The majority of patients received a single RT fraction of 7 Gy, median age was 62, with a prevalence of male and hip as most frequently involved site. Radiological studies and clinical examination were performed in all patients during the follow-up period to evaluate both treatment efficacy and acute or late toxicity. Results With a median follow up of 67 months, 23 patients had a complete response (CR) with excellent results in term of joint mobility. Two patients with CR showed a relapse of HO in the same site 19 and 12 months after treatment, respectively. Seven patients (22,6%) had a partial response (PR) to RT. One patient who reached CR had a history of previous irradiation in the same site 16 years before. No acute or late reactions have been reported. Conclusion Our data confirm safety and efficacy of RT in preventing HO, especially in high-risk patients, preferring a single fraction of 7 Gy.
ISSN:0033-8362
1826-6983
DOI:10.1007/s11547-018-0853-z