Article

A systematic review of the literature to determine whether in patients
with neurological heterotopic ossification (NHO) after traumatic brain injury,
the extent of the neurological sequelae, the timing of surgery and the extent of
the initial NHO affect the risk of NHO recurrence.
DATA SOURCES: We searched
MEDLINE via PubMed and Cochrane library for articles published up to June 2015.
Results were compared with epidemiological studies using data from the BANKHO
database of 357 patients with central nervous system (CNS) lesions who underwent
539 interventions for troublesome HO. RESULTS:
A large number of studies were
published in the 1980s and 1990s, most showing poor quality despite being
performed by experienced surgical teams. Accordingly, results were contradictory
and practices heterogeneous. Results with the BANKHO data showed troublesome NHO
recurrence not associated with aetiology, sex, age at time of CNS lesion,
multisite HO, or "early" surgery (before 6months). Equally, recurrence was not
associated with neurological sequelae or disease extent around the joint.
CONCLUSIONS: The recurrence of NHO is not affected by delayed surgery,
neurological sequelae or disease extent around the joint. Surgical excision of
NHO should be performed as soon as comorbid factors are under control and the NHO
is sufficiently constituted for excision.
CI - Copyright (c) 2016 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS