A new classification of peri-articular heterotopic ossification of the hip associated with neurological injury 3D CT SCAN ASSESSMENT AND INTRA-OPERATIVE FINDINGS

作者：Arduini M; Mancini F; Farsetti P; Piperno A; Ippolito E^*

来源：Bone & Joint Journal, 2015, 97B(7): 899-904.

DOI：10.1302/0301-620X.97B7.35031

In this paper we propose a new classification of neurogenic peri-articular heterotopic ossification (HO) of the hip based on three-dimensional (3D) CT, with the aim of improving pre-operative planning for its excision.
A total of 55 patients (73 hips) with clinically significant HO after either traumatic brain or spinal cord injury were assessed by 3D-CT scanning, and the results compared with the intra-operative findings.
At operation, the gross pathological anatomy of the HO as identified by 3D-CT imaging was confirmed as affecting the peri-articular hip muscles to a greater or lesser extent. We identified seven patterns of involvement: four basic (anterior, medial, posterior and lateral) and three mixed (anteromedial, posterolateral and circumferential). Excellent intra-and inter-observer agreement, with kappa values > 0.8, confirmed the reproducibility of the classification system.
We describe the different surgical approaches used to excise the HO which were guided by the 3D-CT findings. Resection was always successful.
3D-CT imaging, complemented in some cases by angiography, allows the surgeon to define the 3D anatomy of the HO accurately and to plan its surgical excision with precision.

• 出版日期2015-7