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Heterotopic ossification in the knee following retrograde nailing of a femur fracture

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Abstract

Background

Heterotopic ossification (HO) is a pathologic bone formation in extra skeletal tissue and articular space. This was an objection to nailing of femur fractures across the knee; however, this has not been the case in many thousands of cases. Nonetheless, we present a patient in who placement of a retrograde nail resulted in calcification in the knee requiring excision.

Case presentation

A 42-year-old male presented to the clinic complaining of pain, popping, clicking, and mocking in the right knee, especially in the patellar region. Nine months prior he suffered an ipsilateral femur fracture that was treated with a retrograde intramedullary nail. X-ray and CT scan were used to confirm the presentation of a heterotopic bone mass in the Hoffa area of the right knee. The patient underwent an arthrotomy for excision of the bone mass. The bone mass was excised, but bone in the ACL was not removed. The patient experienced pain relief and improved range of motion following excision.

Conclusion

Intraarticular heterotopic ossification is an infrequent event. We present a case of heterotopic ossification in the knee following retrograde nailing. The patient experienced improved symptoms and range of motion after excision of the intraarticular heterotopic bone mass.

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Funding

No funding was received to assist with the preparation of this manuscript. No funding was received for conducting this study. No funds, grants, or other support was received.

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Authors and Affiliations

  1. University of Louisville School of Medicine, 500 S. Preston St, Louisville, KY, 40202, USA

    Arun C. Nadar

  2. Department of Orthopaedic Surgery, University of Louisville, 550 S. Jackson St., 1st Floor ACB, Louisville, KY, 40202, USA

    David Seligson

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  1. Arun C. Nadar
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  2. David Seligson
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Dr. Davd Seligson, MD is a consultant for Stryker Trauma. Mr. Nadar has no disclosures. The authors did not receive support from any organization for the submitted work.

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Correspondence to David Seligson.

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Nadar, A.C., Seligson, D. Heterotopic ossification in the knee following retrograde nailing of a femur fracture. Eur J Orthop Surg Traumatol 33, 3181–3184 (2023). https://doi.org/10.1007/s00590-023-03491-4

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  • DOI: https://doi.org/10.1007/s00590-023-03491-4

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