Primary Versus Secondary Radiotherapy for Heterotopic Ossification Prevention About the Elbow.
Journal
Journal of orthopaedic trauma
ISSN: 1531-2291
Titre abrégé: J Orthop Trauma
Pays: United States
ID NLM: 8807705
Informations de publication
Date de publication:
01 Feb 2022
01 Feb 2022
Historique:
accepted:
21
05
2021
pubmed:
30
5
2021
medline:
28
1
2022
entrez:
29
5
2021
Statut:
ppublish
Résumé
To examine the efficacy and safety of radiotherapy for the prevention of heterotopic ossification (HO) about the elbow. Retrospective chart review. Level 1 trauma center. Two hundred and twenty-nine patients who received prophylactic radiotherapy (XRT) over a 15-year period were identified. Patients were included if they received XRT to the elbow joint and had at least 12 weeks of follow-up after XRT. Fifty-four patients were ultimately included. All patients were treated with a single dose of 7 Gy. Ninety-eight percentage of patients received XRT within 24 hours after surgery, and all patients received XRT within 72 hours after surgery. The primary study measures evaluated were the presence or absence of clinically symptomatic HO and the presence of radiographic HO after XRT to the elbow joint. Eighteen patients were treated with XRT after a traumatic injury requiring surgery (primary prophylaxis), and 36 were treated with XRT after excision surgery to remove HO which had already formed (secondary prophylaxis). In the primary cohort, 16.7% developed symptomatic HO after XRT and 11.1% required surgery to resect the heterotopic bone. In the secondary cohort, 11.1% developed symptomatic HO after surgery and XRT and 5.5% required resection surgery. No secondary malignancies were identified. Our findings suggest that XRT for elbow HO may be safe and effective for both primary and secondary HO. XRT for HO was not shown to be associated with radiation-induced sarcoma in this series, at least in the short term. Further study in a large patient population with extended follow-up is required to better characterize populations at high risk for development of HO and secondary malignancy. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Identifiants
pubmed: 34050084
doi: 10.1097/BOT.0000000000002188
pii: 00005131-202202000-00012
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e56-e61Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors report no conflict of interest.
Références
Vasileiadis GI, Ramazanian T, Kamaci S, et al. Loss of pronation-supination in patients with heterotopic ossification around the elbow. J Shoulder Elbow Surg. 2019;28:1406–1410.
Yu S, Chen M, Fan C. Team approach: elbow contracture due to heterotopic ossification. JBJS Rev. 2017;5:55.
Zhang Z, Zhang Y, Wang Z, et al. Incidence of and risk factors for the development of asymptomatic heterotopic ossification after elbow fracture fixation. J Int Med Res. 2019;48:300060519877324.
Ranganathan K, Loder S, Agarwal S, et al. Heterotopic ossification: basic-science principles and clinical correlates. J Bone Joint Surg Am. 2015;97:1101–1111.
Agarwal S, Loder S, Levi B. Heterotopic ossification following upper extremity injury. Hand Clin. 2017;33:363–373.
Baldwin K, Hosalkar HS, Donegan DJ, et al. Surgical resection of heterotopic bone about the elbow: an institutional experience with traumatic and neurologic etiologies. J Hand Surg Am. 2011;36:798–803.
Abrams GD, Bellino MJ, Cheung EV. Risk factors for development of heterotopic ossification of the elbow after fracture fixation. J Shoulder Elbow Surg. 2012;21:1550–1554.
Foruria AM, Augustin S, Morrey BF, et al. Heterotopic ossification after surgery for fractures and fracture-dislocations involving the proximal aspect of the radius or ulna. J Bone Joint Surg Am. 2013;95:e66.
Shukla DR, Pillai G, McAnany S, et al. Heterotopic ossification formation after fracture-dislocations of the elbow. J Shoulder Elbow Surg. 2015;24:333–338.
Pugh DM, Wild LM, Schemitsch EH, et al. Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. J Bone Joint Surg Am. 2004;86:1122–1130.
Hong CC, Nashi N, Hey HW, et al. Clinically relevant heterotopic ossification after elbow fracture surgery: a risk factors study. Orthop Traumatol Surg Res. 2015;101:209–213.
Haglin JM, Kugelman DN, Christiano A, et al. Open surgical elbow contracture release after trauma: results and recommendations. J Shoulder Elbow Surg. 2018;27:418–426.
Marti RK, Kerkhoffs GM, Maas M, et al. Progressive surgical release of a posttraumatic stiff elbow. Technique and outcome after 2–18 years in 46 patients. Acta Orthop Scand. 2002;73:144–150.
Gundlach U, Eygendaal D. Surgical treatment of posttraumatic stiffness of the elbow: 2-year outcome in 21 patients after a column procedure. Acta Orthop. 2008;79:74–77.
Robinson CG, Polster JM, Reddy CA, et al. Postoperative single-fraction radiation for prevention of heterotopic ossification of the elbow. Int J Radiat Oncol Biol Phys. 2010;77:1493–1499.
Mishra MV, Austin L, Parvizi J, et al. Safety and efficacy of radiation therapy as secondary prophylaxis for heterotopic ossification of non-hip joints. J Med Imaging Radiat Oncol. 2011;55:333–336.
Ploumis A, Belbasis L, Ntzani E, et al. Radiotherapy for prevention of heterotopic ossification of the elbow: a systematic review of the literature. J Shoulder Elbow Surg. 2013;22:1580–1588.
Hamid N, Ashraf N, Bosse MJ, et al. Radiation therapy for heterotopic ossification prophylaxis acutely after elbow trauma: a prospective randomized study. J Bone Joint Surg Am. 2010;92:2032–2038.
Strauss JB, Wysocki RW, Shah A, et al. Radiation therapy for heterotopic ossification prophylaxis afer high-risk elbow surgery. Am J Orthop (Belle Mead NJ). 2011;40:400–405.
Heyd R, Buhleier T, Zamboglou N. Radiation therapy for prevention of heterotopic ossification about the elbow. Strahlenther Onkol. 2009;185:506–511.
Yolcu YU, Wahood W, Goyal A, et al. Factors associated with higher rates of heterotopic ossification after spinal cord injury: a systematic review and meta-analysis. Clin Neurol Neurosurg. 2020;195:105821.
Elhassan Y, Abdelhaq A, Piggott RP, et al. Heterotopic ossification following acetabular fixation: incidence and risk factors: 10-year experience of a tertiary centre. Injury. 2016;47:1332–1336.
Hayashi D, Gould ES, Ho C, et al. Severity of heterotopic ossification in patients following surgery for hip fracture: a retrospective observational study. BMC Musculoskelet Disord. 2019;20:348.
Davis G, Patel RP, Tan TL, et al. Ethnic differences in heterotopic ossification following total hip arthroplasty. Bone Joint J. 2016;98-B:761–766.
Mahmood S, Vu K, Tai P, et al. Radiation-induced second malignancies. Anticancer Res. 2015;35:2431–2434.
Makimoto Y, Yamamoto S, Takano H, et al. Imaging findings of radiation-induced sarcoma of the head and neck. Br J Radiol. 2007;80:790–797.
Kamran SC, Berrington de Gonzalez A, Ng A, et al. Therapeutic radiation and the potential risk of second malignancies. Cancer. 2016;122:1809–1821.
Mourad WF, Packianathan S, Shourbaji RA, et al. Radiation-induced sarcoma following radiation prophylaxis of heterotopic ossification. Pract Radiat Oncol. 2012;2:151–154.
Farris MK, Chowdhry VK, Lemke S, et al. Osteosarcoma following single fraction radiation prophylaxis for heterotopic ossification. Radiat Oncol. 2012;7:140.
Rosenberg DM, Onderdonk B, Majeed NK, et al. Radiation-induced sarcoma after heterotopic ossification prophylaxis: a case report. JBJS Case Connect. 2019;9:e0146.
Rogers P, McKibbin PE, Williams G. Acute fenfluramine administration reduces neuropeptide Y concentrations in specific hypothalamic regions of the rat: possible implications for the anorectic effect of fenfluramine. Peptides. 1991;12:251–255.
Meyers C, Lisiecki J, Miller S, et al. Heterotopic ossification: a comprehensive review. JBMR Plus. 2019;3:e10172.
Joo MW, Kang YK, Ogura K, et al. Post-radiation sarcoma: a study by the eastern asian musculoskeletal oncology group. PLoS One. 2018;13:e0204927.
Song Y, Zhang Y, He M, et al. Enhancing the production of poly-gamma-glutamate in Bacillus subtilis ZJS18 by the heat- and osmotic shock and its mechanism. Prep Biochem Biotechnol. 2020;50:1–8.