Parikh Sarthak, Tacy Collin, Gomez Osmanny, Corces Arturo
Department of Orthopedic Surgery, Larkin Community Hospital, Miami, USA.
Department of Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.
Cureus. 2022 Apr 9;14(4):e23977. doi: 10.7759/cureus.23977. eCollection 2022 Apr.
Heterotopic ossification (HO) is the formation of bone within extraskeletal soft tissue. The development of mature lamellar bone within soft tissues can be acquired in cases like trauma. Clinical manifestations of HO primarily include pain at the site of the extraskeletal ossification and limited range of motion or function when it involves a joint. This case report presents a 56-year-old man with severe HO. His past medical history included a traumatic hip dislocation in 1996. He denied any other past medical, family, or surgical history. This patient had severely limited range of motion and difficulty performing activities of daily living like going up and down the stairs and getting up from a seated position. After failing conservative therapy with non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy, a non-cemented dual mobility hip replacement system was used to treat this patient. A non-cemented dual mobility hip replacement system was chosen because the patient had significant bone loss and was relatively young. The dual mobility system significantly reduces the risk of dislocation and is a good option for younger patients who require more stability in their hips. The patient progressed well with a full range of motion and no pain. There was no evidence of HO recurrence. Treatment of HO with a total hip replacement, let alone a dual mobility system, is not prevalent throughout the literature. Furthermore, cemented total hip arthroplasty has been associated with increased recurrence of HO, which is why we elected to use a non-cemented technique. Osteoplasty is typically the mainstay of treatment for HO. The purpose of this case report is to introduce an incident of HO treated with a non-cemented dual mobility system and emphasize its use in young, middle-aged, or active patients who have bone loss and require increased stability.
异位骨化（HO）是指在骨骼外软组织内形成骨组织。在创伤等情况下，软组织内可形成成熟的板层骨。HO的临床表现主要包括骨骼外骨化部位的疼痛，以及当累及关节时活动范围或功能受限。本病例报告介绍了一名患有严重HO的56岁男性。他的既往病史包括1996年外伤性髋关节脱位。他否认有任何其他既往病史、家族病史或手术史。该患者的活动范围严重受限，在进行诸如上下楼梯和从坐位起身等日常生活活动时存在困难。在使用非甾体抗炎药（NSAIDs）和物理治疗的保守治疗失败后，采用了非骨水泥双动髋关节置换系统来治疗该患者。选择非骨水泥双动髋关节置换系统是因为该患者有明显的骨质流失且相对年轻。双动系统显著降低了脱位风险，对于需要髋关节更稳定的年轻患者来说是一个不错的选择。患者术后活动范围完全恢复且无疼痛，恢复良好。没有HO复发的迹象。在整个文献中，用全髋关节置换术治疗HO并不普遍，更不用说双动系统了。此外，骨水泥型全髋关节置换术与HO复发增加有关，这就是我们选择使用非骨水泥技术的原因。骨成形术通常是HO治疗的主要方法。本病例报告的目的是介绍一例采用非骨水泥双动系统治疗HO的病例，并强调其在有骨质流失且需要增加稳定性的年轻、中年或活跃患者中的应用。
