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Thread: How to manage Heterotopic ossification

  1. #1
    Senior Member GoTWHeeLs's Avatar
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    Question How to manage Heterotopic ossification

    For the past 18 months I've had some extreme physical changes in the past two years. In October of 2014 I began to have back pain that felt like a lot of pressure in my lower left back. It also feels like an extremely tight muscle. I thought it was a Baclofen issue and actually had a Baclofen pump placed and only created more issues. I've had it removed and am back where I was a year ago, recently I asked for a ct scan of my hips because my dad and brother have bi lateral necrosis of there hips. This is how I found out about the HO. Im waiting for my bone scan to be scheduled. I'm going to go inpatient for two weeks for physical therapy.

    My my left hip has 10 cm of growth and the right has 12 cm. I'm hoping there is some advice out there that will help me manage this so I can get my life back on track. The range of motion I'm doing is not cutting it. Pain meds only dull it/me. Are there any suggestions out there?

    Thank you so much.
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  2. #2
    Heterotopic ossification (HO) is the formation of ectopic bone within skeletal soft tissues. It is treated with non-steroidal anti-inflammatory drugs, biphosphate therapy and external beam radiation therapy. Of these, radiation therapy is possibly more effective but is much more expensive than other available preventative measures.

    Surgical resection is indicated when the ectopic bone causes breakdown of the overlying skin, interferes with prosthetic fitting, or limits mobility of the extremity.

    Physical therapy is extremely helpful. Good luck with your treatment.

    pbr

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    Senior Member GoTWHeeLs's Avatar
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    So, if the bone is still "hot" there are available therapies to stop the bone from growing? I was under the impression that surgery was an option but my doctor advised against it. She said the next step is to take a "hot or not" bone scan. I have a pacemaker so no mri but what other options are available for imaging in this circumstance?
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  5. #5
    Surgery for HO should not be done while the bone is still actively growing. It must have "matured". Doing surgery too early can cause it to actually get worse. Surgery is always difficult in HO as it tends to be very bloody and vascular. Great care must be taken to control bleeding, avoid hematomas, or infections post-operatively.

    The only way to tell when this is is to do periodic bone scans. This is not an MRI. They remove a small vial of your blood, spin down the white blood cells, mix them with a short acting radio-opaque substance, then reinject them into your body. The white cells will go to anyplace that is infected or has actively growing bone or inflammation. Active areas are often called "hot spots".

    Until then drug therapy for HO has traditionally been Didronel and/or Indocin. You may need to take these for years, as stopping the Didronel when HO is not yet mature can cause it to come back with a vengeance.

    (KLD)

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    Senior Member GoTWHeeLs's Avatar
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    I've done the bone scan and two weeks of inpatient physical therapy. Results of the bone scan showed no new bone growth. Now it's just managing it with stretching? I've lost little range of motion but am still feeling like I'm sitting on a jagged rock, and can't tell if the back pain is from a bad disc or the H.O. This whole experience has been extremely difficult. I'm still unaware of if I should seek out other options/opinions or just learn to get on learning to deal with it. ����
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