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Abstract：
BACKGROUND: Heterotopic ossification (HO) is the formation of bone in soft tissue resultant from inflammatory processes. Lesion formation after arthroscopic procedures is an uncommon but challenging complication. Optimal prophylaxis and management strategies have not been clearly defined.
OBJECTIVE: To present a scoping review of the pathophysiology, risk factors, diagnostic modalities, prophylaxis recommendations, and current treatment practices concerning HO after arthroscopic management of orthopaedic injuries.
METHODS: Scoping review; Level of evidence, 4.
METHODS: A scoping review via a PubMed search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. The search strategy was based on the terms \"heterotopic ossification\" AND \"arthroscopy.\" The clinical outcomes review included studies on the arthroscopic management of orthopaedic injuries in which the primary subject matter or a secondary outcome was the development of HO. An analysis of the pathophysiology, diagnostic modalities, and management options was reported.
RESULTS: A total of 43 studies (33,065 patients) reported on HO after hip arthroscopy, while 21 (83 patients) collectively reported on HO after arthroscopic procedures to the shoulder, elbow, knee, or ankle; however, management techniques were not standardized. Identified risk factors for HO included male sex and mixed impingement pathology, while intraoperative capsular management was not suggested as a contributing factor. Diagnosis of ossification foci was performed using radiography and computed tomography. The rate of HO after hip arthroscopy procedures approached 46% without prophylaxis, and administration of nonsteroidal anti-inflammatory drugs (NSAIDs) decreased occurrence rates to 4% but carries associated risks. External beam radiation has not been exclusively studied for use after arthroscopic procedures.
CONCLUSIONS: HO is a known complication after arthroscopic management of orthopaedic injuries. NSAID prophylaxis has been demonstrated to be effective after hip arthroscopy procedures. Patients with persistent symptoms and mature lesions may be indicated for surgical excision, although variability is present in patient-reported outcome scores postoperatively.
OBJECTIVE: To present a scoping review of the pathophysiology, risk factors, diagnostic modalities, prophylaxis recommendations, and current treatment practices concerning HO after arthroscopic management of orthopaedic injuries.
METHODS: Scoping review; Level of evidence, 4.
METHODS: A scoping review via a PubMed search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. The search strategy was based on the terms \"heterotopic ossification\" AND \"arthroscopy.\" The clinical outcomes review included studies on the arthroscopic management of orthopaedic injuries in which the primary subject matter or a secondary outcome was the development of HO. An analysis of the pathophysiology, diagnostic modalities, and management options was reported.
RESULTS: A total of 43 studies (33,065 patients) reported on HO after hip arthroscopy, while 21 (83 patients) collectively reported on HO after arthroscopic procedures to the shoulder, elbow, knee, or ankle; however, management techniques were not standardized. Identified risk factors for HO included male sex and mixed impingement pathology, while intraoperative capsular management was not suggested as a contributing factor. Diagnosis of ossification foci was performed using radiography and computed tomography. The rate of HO after hip arthroscopy procedures approached 46% without prophylaxis, and administration of nonsteroidal anti-inflammatory drugs (NSAIDs) decreased occurrence rates to 4% but carries associated risks. External beam radiation has not been exclusively studied for use after arthroscopic procedures.
CONCLUSIONS: HO is a known complication after arthroscopic management of orthopaedic injuries. NSAID prophylaxis has been demonstrated to be effective after hip arthroscopy procedures. Patients with persistent symptoms and mature lesions may be indicated for surgical excision, although variability is present in patient-reported outcome scores postoperatively.
摘要：
背景：异位骨化（HO）是由炎症过程引起的软组织中的骨形成。关节镜手术后的病变形成是一种罕见但具有挑战性的并发症。最佳预防和管理策略尚未明确定义。
目的：提供病理生理学的范围审查，危险因素，诊断方式，预防建议，以及关节镜治疗骨科损伤后HO的当前治疗方法。
方法：范围审查；证据水平，4.
方法：根据PRISMA（系统评价和Meta分析的首选报告项目）指南，通过PubMed搜索进行范围审查。搜索策略基于术语“异位骨化”和“关节镜”。“临床结果综述包括对骨科损伤的关节镜治疗的研究，其中主要主题或次要结果是HO的发展。病理生理学分析，诊断方式，并报告了管理选择。
结果：共有43项研究（33,065例患者）报告了髋关节镜检查后的HO，而21（83例）在肩关节镜手术后共同报告了HO，弯头,膝盖,或脚踝；然而，管理技术不规范。确定的HO危险因素包括男性和混合性撞击病理，而术中包膜管理不被认为是一个促成因素。骨化灶的诊断是使用X线摄影和计算机断层扫描进行的。髋关节镜手术后HO的发生率接近46％，没有预防，非甾体类抗炎药(NSAIDs)的使用将发生率降低至4%,但存在相关风险.尚未专门研究在关节镜手术后使用外部光束辐射。
结论：HO是骨科损伤关节镜治疗后的一种已知并发症。NSAID预防已被证明在髋关节镜检查手术后是有效的。有持续症状和成熟病变的患者可能需要手术切除，尽管术后患者报告的结局评分存在差异.
目的：提供病理生理学的范围审查，危险因素，诊断方式，预防建议，以及关节镜治疗骨科损伤后HO的当前治疗方法。
方法：范围审查；证据水平，4.
方法：根据PRISMA（系统评价和Meta分析的首选报告项目）指南，通过PubMed搜索进行范围审查。搜索策略基于术语“异位骨化”和“关节镜”。“临床结果综述包括对骨科损伤的关节镜治疗的研究，其中主要主题或次要结果是HO的发展。病理生理学分析，诊断方式，并报告了管理选择。
结果：共有43项研究（33,065例患者）报告了髋关节镜检查后的HO，而21（83例）在肩关节镜手术后共同报告了HO，弯头,膝盖,或脚踝；然而，管理技术不规范。确定的HO危险因素包括男性和混合性撞击病理，而术中包膜管理不被认为是一个促成因素。骨化灶的诊断是使用X线摄影和计算机断层扫描进行的。髋关节镜手术后HO的发生率接近46％，没有预防，非甾体类抗炎药(NSAIDs)的使用将发生率降低至4%,但存在相关风险.尚未专门研究在关节镜手术后使用外部光束辐射。
结论：HO是骨科损伤关节镜治疗后的一种已知并发症。NSAID预防已被证明在髋关节镜检查手术后是有效的。有持续症状和成熟病变的患者可能需要手术切除，尽管术后患者报告的结局评分存在差异.
