title: Recurrence of heterotopic ossification after removal in patients with traumatic brain injury: A systematic review.
abstract: OBJECTIVE
  A systematic review of the literature to determine whether in patients with neurological heterotopic ossification (NHO) after traumatic brain injury, the extent of the neurological sequelae, the timing of surgery and the extent of the initial NHO affect the risk of NHO recurrence.
  
  
  METHODS
  We searched MEDLINE via PubMed and Cochrane library for articles published up to June 2015. Results were compared with epidemiological studies using data from the BANKHO database of 357 patients with central nervous system (CNS) lesions who underwent 539 interventions for troublesome HO.
  
  
  RESULTS
  A large number of studies were published in the 1980s and 1990s, most showing poor quality despite being performed by experienced surgical teams. Accordingly, results were contradictory and practices heterogeneous. Results with the BANKHO data showed troublesome NHO recurrence not associated with aetiology, sex, age at time of CNS lesion, multisite HO, or "early" surgery (before 6months). Equally, recurrence was not associated with neurological sequelae or disease extent around the joint.
  
  
  CONCLUSIONS
  The recurrence of NHO is not affected by delayed surgery, neurological sequelae or disease extent around the joint. Surgical excision of NHO should be performed as soon as comorbid factors are under control and the NHO is sufficiently constituted for excision.
authors.affiliation: Department of physical medicine and rehabilitation, hôpital Raymond-Poincaré, AP-HP, CIC-IT 1429, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
authors.forename: Waleed
authors.initials: W
authors.lastname: Almangour
authors.affiliation: Department of physical medicine and rehabilitation, hôpital Raymond-Poincaré, AP-HP, CIC-IT 1429, 104, boulevard Raymond-Poincaré, 92380 Garches, France; Université Versailles-Saint-Quentin-en-Yvelines, HANDI-ReSP (EA4047), UFR des sciences de la santé-Simone-Veil, Versailles, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Schnitzler
authors.affiliation: Department of physical medicine and rehabilitation, hôpital Raymond-Poincaré, AP-HP, CIC-IT 1429, 104, boulevard Raymond-Poincaré, 92380 Garches, France; Université Versailles-Saint-Quentin-en-Yvelines, « End:icap » U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Salga
authors.affiliation: Université Versailles-Saint-Quentin-en-Yvelines, « End:icap » U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Service de chirurgie orthopédique, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Debaud
authors.affiliation: Université Versailles-Saint-Quentin-en-Yvelines, « End:icap » U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Service de chirurgie orthopédique, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Denormandie
authors.affiliation: Department of physical medicine and rehabilitation, hôpital Raymond-Poincaré, AP-HP, CIC-IT 1429, 104, boulevard Raymond-Poincaré, 92380 Garches, France; Université Versailles-Saint-Quentin-en-Yvelines, « End:icap » U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Service de médecine physique et de réadaptation, service de santé des armées, hôpital d'instruction des armées-Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France. Electronic address: francois.genet@rpc.aphp.fr.
authors.forename: François
authors.initials: F
authors.lastname: Genêt
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D009999:Ossification, Heterotopic / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology; D012008:Recurrence
keywords: Head injury; Heterotopic ossification; Recurrence; Traumatic brain injury