Table 6: Radiation Therapy for Treatment of Heterotopic Ossification

Author Year
Country
PEDro Score
Research Design
Total Sample Size

Methods Results

Museler et al., 2017
Germany
Case Series
N=244

 

Population: Mean age: 46.4 yr; Gender: males=207, females=37; Severity of injury: AIS: A=220, B=8, C=12, D=4.
Interventions: Single-dose radiation therapy at the hip for HO. Mean time of treatment was 4.9 days. Treatment was administered with either 15 MV or 6 MV.
Outcome Measures: HO recurrence, side effect due to radiation. 
1. Of the 244 patients, 13 experienced recurrence of HO. All 13 patients initially experienced HO in both hips. Of the 444 initial cases of HO, there were 26 instances of recurrence.

2. No patients experienced negative side-effects as a result of radiation treatment.

Sautter-Bihl et al. 2001
Germany
Case series
N=52

Population: Mean age=33 yr; Gender: males=44, females=8.
Treatment: Patients received a single dose of radiotherapy 2-10 Gy through a linear accelerator at 6-8 MV photons.
Outcome Measures: Efficacy, Brooker classification, and adverse effects.
1. Prevention of HO was seen in 71% of (41 primarily treated, 9 resected) joints.

2. Radiotherapy treatment did not result in a regression of the Brooker score in any patient.

3. An increase in two Brooker score grades was seen in two joints (1 knee, 1 hip)

4. No adverse effects due to therapy occurred.

5. 16 of 32 hips treated only with radiotherapy (50%) did not show any abnormalities on follow-up.

6. No progression of HO was noted in 30/36 subjects (83%).

7. Re-ossification after therapy which led to a decrease in joint mobility was noted in three subjects.

Sautter-Bihl et al. 2000
Germany
Case series
N=36

Population: Age range=17-59 yr; Gender: males=32, females=4; Follow-up=4-98 mo.
Treatment: 25/36 subjects received 10 Gy radiotherapy in fraction of 2-2.5Gy, while four patients received higher doses. In phase 2 seven subjects received a single does of irradiation with 8Gy. In total, 46 joints were irradiated.
Outcome Measures: Progression of HO and complications.
1. 16 of the 32 hips treated with radiotherapy only did not show any abnormalities on follow-up.

2. No progression of HO was noted in 30/36 subjects.

3. Re-ossification after therapy, which led to a decrease in joint mobility was noted in three subjects.

Note: F/U=follow-up

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