Radiation Therapy

Radiation therapy or radiotherapy, which is the use of ionizing radiation for therapeutic ends, has been proposed as a possible adjunct treatment for HO.

Table: Radiation Therapy in Treatment of Heterotopic Ossification Post SCI


Sautter-Bihl et al. (2000) studied 36 patients with HO of whom 27 patients (32 joints) received radiotherapy when ossification was minimal. 11 patients (13 joints) had obvious ossifications, which had to be resected. Post-op radiotherapy was performed 24-36 hours post-operatively. Two patients received radiotherapy both before and after surgery. Mean duration of follow-up was 23.6 months. 30 of the 36 irradiated patients showed no progression of HO. In 3 patients, reossification after therapy resulted in a moderate decrease in joint mobility.

In the follow-up case series by Sautter-Bihl et al. (2001), the authors examined the effectiveness of radiotherapy administered to 52 SCI patients. Radiotherapy effectively prevented primary and secondary HO post-surgical excision in 71% of patients. However, treatment did not result in regression of HO once developed, as measured by the Brooker scale. Two joints increased in Brooker score, although neither of them developed any functional impairment.


There is limited Level 4 evidence (from 2 case series studies; Sautter-Bihl et al. 2000; Sautter-Bihl et al. 2001) that radiotherapy reduces the progression of heterotopic ossification.

  • Radiotherapy can reduce the progression of heterotopic ossification.