Heterotopic Ossification


Heterotopic ossification (HO) is conversion of soft tissues into bone. It often occurs after injury or surgery in a predisposed person. Brain and spinal cord injuries cause extensive HO even without local tissue trauma. It is the most common complication after hip arthroscopy in Dr. Prasad Gourineni’s experience. Persistent or recurrent pain and loss of motion are the primary complaints. HO after most hip surgery is in Gluteus minimus and Iliocapsularis muscles. Seems to be related to extensive arthroscopic bone shaving and acetabular osteotomies.

Symptomatic HO can be excised. We do not wait for maturation in the elbow or the hip. Once I can see the extent of the HO and the patient wants excision, I do it. We recommend immediate post-op radiation or Indomethacin for 6 weeks to prevent recurrence. 

Heterotopic ossification of left hip developed a few months after periacetabular osteotomy