Embolization followed by resection of the heterotopic hip joint ossification with spinal cord injury

Background: Heterotopic ossification of large joints, such as knees and hips, has been reported after spinal cord injury, possibly leading to decreased activity of daily living due to a limited range of motion of the affected joint. Therefore, heterotopic ossification resection is performed to improve the range of motion, but it might cause massive bleeding as a complication. Methods: In this case, the patient had a history of spinal cord injury and developed heterotopic ossification after the left hip injury. He had left hip ankylosis and could not transfer to a wheelchair by himself; therefore, heterotopic ossification resection was planned. On conducting contrast-enhanced computed tomography, the supplying arteries extending to the heterotopic ossification could be identified. A day before the surgery, embolization of the branches by interventional radiology was performed. Results: Heterotopic ossification resection was performed with an 820-ml blood loss. Postoperative rehabilitation was continued, and range of motion continued to improve without heterotopic ossification recurrence 2 years post-surgery. Conclusions: The combination of preoperative contrast-enhanced computed tomography and embolization was useful in treating heterotopic ossification. (c) 2022 The Authors. Published by Elsevier B.V. on behalf of The Japanese Orthopaedic Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).