Heterotopic ossification - ectopic (myositis ossificans) - Treatment

Salvage therapy:During the acute inflammatory phase of the patient requires rest the affected joint in functional position, and a special gym program should be initiated as soon as possible. The role of the gymnastics program has not yet been studied. For patients with neurological injuries, maintain a joint mobilization may be difficult because of pain. The use of joint manipulation is still useful. There is also controversy over the handling of new individuals due risuclui hematoma formation and bone fracture in patients with secondary osteoporosis.Surgical therapy:If surgery to remove heterotopic ossification ectopic bone is necessary only for functional purposes such as improving the position or opportunity ambulatiei or personal care. In general surgery is not performed in May of 18 months early, the injury triggers.Excision should be considered in patients coror limited shoulder movements, elbow to functional limitations, various joints. It indicates whether pressure ulcers result in bone mass. It is contraindicated in patients who demonstrated clinical, radiological and laboratory tests bone metabolic activity. Bone maturation, wait for 1-2 years. Immature bone resection leads to recurrence of 100%. Bleeding is an important problem in surgery. Postsurgical infection leading to amputation. Ectopic bone should be excised when the patient's recovery and limited joint movements.
Radiotherapy:It was studied by heterotopic ossification associated with prevention in patients at high risk of recurrence after hip arthroplasty. It is used in recovering the optimal dose, frequency and duration not established yet. Mesenchymal stem cells that turn into muscle and bone-forming cells are radiosensibile. There is also the risk of malignancy after local radiotherapy.
Pharmacological Therapy:Today heterotopic ossification medical therapy is directed at early stages of the disease. In late stages of development of mature bone is effective medical treatment. Etidronatul is the only drug for the treatment of heterotopic ossification after spinal cord injury.Steroidal anti-inflammatory treatment may be necessary initially until the resolution of inflammation and normalization of C-reactive protein.