Heterotopic Ossification: Basic-Science Principles and Clinical Correlates

J Bone Joint Surg Am. 2015 Jul 1;97(13):1101-11. doi: 10.2106/JBJS.N.01056.


➤ Heterotopic ossification occurs most commonly after joint arthroplasty, spinal cord injury, traumatic brain injury, blast trauma, elbow and acetabular fractures, and thermal injury.➤ The conversion of progenitor cells to osteogenic precursor cells as a result of cell-mediated interactions with the local tissue environment is affected by oxygen tension, pH, availability of micronutrients, and mechanical stimuli, and leads to heterotopic ossification.➤ Radiation and certain nonsteroidal anti-inflammatory medications are important methods of prophylaxis against heterotopic ossification.➤ Well-planned surgical excision can improve patient outcomes regardless of the joint involved or the initial cause of injury.➤ Future therapeutic strategies are focused on targeted inhibition of local factors and signaling pathways that catalyze ectopic bone formation.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Arthroplasty / adverse effects
  • Bone Density Conservation Agents / therapeutic use
  • Humans
  • Ossification, Heterotopic* / diagnosis
  • Ossification, Heterotopic* / etiology
  • Ossification, Heterotopic* / therapy
  • Risk Factors
  • Wounds and Injuries / complications


  • Anti-Inflammatory Agents, Non-Steroidal
  • Bone Density Conservation Agents