TAILIEUCHUNG - Espandar and Haghpanah Journal of Orthopaedic Surgery and Research 2010, 5:39

Espandar and Haghpanah Journal of Orthopaedic Surgery and Research 2010, 5:39 CASE REPORT Case report Open Access Acceptable outcome following resection of bilateral large popliteal space heterotopic ossification masses in a spinal cord injured patient: a case report Ramin Espandar* and Babak Haghpanah Abstract Spinal cord injury is a well-known predisposing factor for development of heterotopic ossification around the joints especially hip and elbow. Heterotopic ossification about the knee is usually located medially, laterally or anteriorly; besides, the knee is generally fixed in flexion. There are only a few reports of heterotopic bone formation at the posterior aspect of the knee (popliteal space) and fixation. | Espandar and Haghpanah Journal of Orthopaedic Surgery and Research 2010 5 39 http content 5 1 39 éHMÌ JOURNAL OF ORTHOPAEDIC MBs SURGERY AND RESEARCH CASE REPORT Open Access Acceptable outcome following resection of bilateral large popliteal space heterotopic ossification masses in a spinal cord injured patient a case report Ramin Espandar and Babak Haghpanah Abstract Spinal cord injury is a well-known predisposing factor for development of heterotopic ossification around the joints especially hip and elbow. Heterotopic ossification about the knee is usually located medially laterally or anteriorly besides the knee is generally fixed in flexion. There are only a few reports of heterotopic bone formation at the posterior aspect of the knee popliteal space and fixation of both knees in extension so there is little experience in operative management of such a problem. Here we present a 39-years old paraplegic man who was referred to us five years after trauma with a request of above knee amputation due to sever impairment of his life style and adaptive capacity for daily living because of difficulties in using wheelchair. The principle reason for the impairment was fixed full extension of both knees as the result of bilateral large heterotopic ossification masses in popliteal fossae. The bony masses were surgically resected with acceptable outcome. The anatomic position of the ossified masses as well as ankylosis of both knees in full extension and the acceptable functional outcome of surgery which was done after a long period of five years following injury makes this case unique. Background Heterotopic ossification HO is formation of lamellar bone within the soft tissue structures. During its course of evolution HO turns into mature bone structure with cortex and medullary cavity containing bone marrow cells and variable amount of hematopoiesis. The exact mechanism by which such a process begins and evolves is not clearly understood but various .

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