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Impact of the Operative Delay and the Degree of Neurologic Sequelae on Recurrence of Excised Heterotopic Ossification in Patients With Traumatic Brain Injury

Genêt, François MD; Chehensse, Clément MD; Jourdan, Claire MD; Lautridou, Christine MD; Denormandie, Philippe MD; Schnitzler, Alexis MD

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP

Journal of Head Trauma Rehabilitation: November/December 2012 - Volume 27 - Issue 6 - p 443–448
doi: 10.1097/HTR.0b013e31822b54ba
Original Articles

The timing of surgery with regard to recurrence risk after neurologic heterotopic ossification (HO) excision is still debated. This study investigated the association between recurrence risk after HO excision in traumatic brain injury (TBI) patients and (1) the operative delay and (2) the degree of neurologic sequelae (Garland status). A case-control study was performed. Patients who developed troublesome HO requiring surgery after TBI with (case, n = 16) or without recurrence (control, n = 64) were retrospectively included. Other matching criteria were sex and age at the time of surgery (± 4 years). The median delay for first HO surgery was 13.7 months (interquartile range: 9.0–37.1) for the case group and 13.2 months (interquartile range: 7.8–30.0) for the control group. No significant link was found between recurrence and operative delay (P = .54), even after inclusion of all matching factors (P = .53), or Garland status (P = .81). The inclusion of Garland status into the model did not change this result (P = .64). After TBI, no link was found between HO operative delay and recurrence. In spite of a common notion of a relationship between initial severity of TBI and HO development, no link was found between HO recurrence risk and the severity of sequelae.

Service de Médecine Physique et de Réadaptation (Drs Genêt, Chehensse, Jourdan, and Schnitzler), Service de chirurgie Orthopédique (Drs Lautridou and Denormandie), CHU R.Poincaré, Garches, France.

Corresponding Author: François Genêt, MD, Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation, 104 Bld Raymond Poincaré, 92380 Garches, France (

The authors declare no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.