Massive heterotopic ossification after hip arthroscopy: A case report

Author(s): Muhammet Zeki Gültekin, YaÅŸar Mahsut Dinçel, Abdullah Heysem DoÄŸan and Emre AÄžCA

Abstract: Heterotopic ossification is a new bone formation that occurs in soft tissue, especially between muscle and joint capsule, which is very common after spinal cord and traumatic brain injuries. It can occur with inflammation as well as with trauma. In this article, we presented a patient who had undergone hip arthroscopy surgery and whose heterotopic ossification had reached a massive size that would affect his daily life. In 2015, a patient applied to an external center clinic with the complaint of pain in the right hip. The patient was 16 years old and practicing martial arts. After various treatments, hip arthroscopy was recommended in June 2016 with the diagnosis of cam-type impingement and he was operated on in June 2017. 3 months after surgery, the patient noticed difficulty in hip movements and radiological imaging showed heterotopic ossification. A daily 75 mg/d Endol treatment was applied for 3 weeks and he received intermittent physical therapy. ESWT (Extracorporeal Shock Wave Therapy) was applied to the patient whose complaints did not improve. The hip flexion of the patient partially recovered and also, he was able to sit partially after ESWT treatment. The patient declared that he had to take a break from the controls due to the pandemic. Open excision and debridement were recommended for the patient's current condition, and hip arthroplasty was offered as a treatment option if necessary. Heterotopic ossification can be seen after hip arthroscopy and can grow to massive sizes, affecting the patient's daily life. It may occur in major surgeries in orthopedics and may occur after hip arthroscopy and, although rarely, reach large dimensions and affect the daily life of the patient. It is important to consider the risk factors associated with heterotopic ossification. Patient selection is important in preventing the occurrence of HO, and appropriate observation, consideration of risk factors before and during the surgical procedure, and appropriate prophylaxis may be beneficial.

DOI: https://doi.org/10.22271/ortho.2022.v8.i1h.3070