title: Impact of the operative delay and the degree of neurologic sequelae on recurrence of excised heterotopic ossification in patients with traumatic brain injury.
abstract: The timing of surgery with regard to recurrence risk after neurologic heterotopic ossification (HO) excision is still debated. This study investigated the association between recurrence risk after HO excision in traumatic brain injury (TBI) patients and (1) the operative delay and (2) the degree of neurologic sequelae (Garland status). A case-control study was performed. Patients who developed troublesome HO requiring surgery after TBI with (case, n = 16) or without recurrence (control, n = 64) were retrospectively included. Other matching criteria were sex and age at the time of surgery (± 4 years). The median delay for first HO surgery was 13.7 months (interquartile range: 9.0-37.1) for the case group and 13.2 months (interquartile range: 7.8-30.0) for the control group. No significant link was found between recurrence and operative delay (P = .54), even after inclusion of all matching factors (P = .53), or Garland status (P = .81). The inclusion of Garland status into the model did not change this result (P = .64). After TBI, no link was found between HO operative delay and recurrence. In spite of a common notion of a relationship between initial severity of TBI and HO development, no link was found between HO recurrence risk and the severity of sequelae.
authors.affiliation: Service de Médecine Physique et de Réadaptation, CHU R.Poincaré, Garches, France. francois.genet@rpc.aphp.fr
authors.forename: François
authors.initials: F
authors.lastname: Genêt
authors.forename: Clément
authors.initials: C
authors.lastname: Chehensse
authors.forename: Claire
authors.initials: C
authors.lastname: Jourdan
authors.forename: Christine
authors.initials: C
authors.lastname: Lautridou
authors.forename: Philippe
authors.initials: P
authors.lastname: Denormandie
authors.forename: Alexis
authors.initials: A
authors.lastname: Schnitzler
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult