Treatment of Heterotopic Ossification

The published literature on treatment of HO provides evidence for non-steroidal anti-inflammatory drugs, warfarin, bisphosphonates, pulse low-intensity electromagnetic field therapy, radiation and surgical excision.

Table 1: Reviews examining the effectiveness of pharmacological, non-pharmacological and surgical management of HO after SCI

Two systematic reviews examined the effectiveness of HO management interventions. Aubut et al. (2011) found that pharmacological interventions were effective in the prophylaxis of HO. Teasell et al. (2010) also found that rofecoxib and indomethacin were effective in preventing HO after SCI. However, only limited evidence supported the use of radiotherapy, warfarin, or Pulse low intensity electromagnetic field therapy (PLIMF) for the prevention of HO after SCI. Once HO developed, only surgical resection was found to be effective, while bisphosphonates such as Etidronate Disodium and pamindronate were supported by limited evidence.