CURRENT CONCEPTS IN RADIOTHERAPY FOR BENIGN DISORDERS

CurrentConceptsinRadiotherapyforBenignDisorders1-0-25kapak

Heterotopic Ossification

Esra GÜMÜŞTEPEa , Hakan GAMSIZb
aGülhane Training and Research Hospital, Clinic of Radiation Oncology, Ankara, Türkiye
bUniversity of Health Sciences Gülhane Faculty of Medicine, Department of Radiation Oncology, Ankara, Türkiye

Gümüştepe E, Gamsız H. Heterotopic ossification. In: Uysal B, Gamsız H, eds. Current Concepts in Radiotherapy for Benign Disorders. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.34-7.

ABSTRACT
Heterotopic ossification (HO) is characterized by the ectopic formation of bone within extra-skeletal soft tissues. It is increasingly recognized as a complication following traumatic brain injury, traumatic amputations, burns, neurological injuries, and major orthopedic surgeries. The clinical signs and symptoms typically manifest 3-12 weeks after triggering events. Early stages may present with pain, fever, joint swelling, followed by joint motion loss and ankylosis. Diagnosis is typically confirmed using conventional radiographs followed by three-phase bone scans. Grade I and II HO generally do not require treatment unless symptomatic or functionally limiting. The gold standard treatment for advanced HO (Grade III and IV) is revision arthroplasty and surgical resection of bone formation. The most common methods to prevent HO are radiotherapy (RT) and indomethacin. Timing is crucial in prophylactic RT. Radiotherapy for HO prophylaxis is well tolerated, with no observed side effects such as wound healing disturbances.

Keywords: Heterotopic ossification; radiotherapy; indomethacin; surgical treatment

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