Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Preoperative arterial embolization of heterotopic ossification around the hip joint

  • Kim, Jin Hyeok (Department of Radiology, Pusan National University Yangsan Hospital) ;
  • Park, Chankue (Department of Radiology, Pusan National University Yangsan Hospital) ;
  • Son, Seung Min (Department of Orthopedic Surgery, Pusan National University Yangsan Hospital) ;
  • Shin, Won Chul (Department of Orthopedic Surgery, Pusan National University Yangsan Hospital) ;
  • Jang, Joo Yeon (Department of Radiology, Pusan National University Yangsan Hospital) ;
  • Jeong, Hee Seok (Department of Radiology, Pusan National University Yangsan Hospital) ;
  • Lee, In Sook (Department of Radiology, Pusan National University Hospital) ;
  • Moon, Tae Young (Department of Radiology, Pusan National University Yangsan Hospital)
  • Received : 2018.04.18
  • Accepted : 2018.05.21
  • Published : 2018.06.30
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Abstract

Heterotopic ossification (HO) around the hip joint is not uncommon following neurological injury. Often, surgical treatment is performed in patients with restricted motion and/or refractory pain due to grade III or IV HO according to Brooker classification. The major complication that occurs as a result of surgical HO removal is perioperative bleeding due to hyper-vascularization of the lesion. Here, we report a case of preoperative embolization in a 51-year-old male patient presenting with restricted bilateral hip range of motion (ROM) due to HO following a spinal cord injury. In the right hip without preoperative arterial embolization, massive bleeding occurred during surgical removal of HO. Thus, the patient received a transfusion postoperatively due to decreased serum hemoglobin levels. For surgery of the left hip, preoperative embolization of the arteries supplying HO was performed. Surgical treatment was completed without bleeding complications, and the patient recovered without a postoperative transfusion. This case highlights that, while completing surgical removal for ROM improvements, orthopedic surgeons should consider preoperative arterial embolization in patients with hip HO.

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References

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