Heterotopic ossification complicating prolonged intubation: case report and review of the literature.

ABSTRACT

BACKGROUND: Within the past decade several reports have been published concerning heterotopic ossification (HO) in adult respiratory distress syndrome patients subjected to prolonged mechanical ventilation. The knee has been the most common site of involvement, which tends to differentiate this entity of HO from those previously described. METHOD: Case report and literature review. FINDINGS: HO associated with prolonged intubation differs in clinical presentation from HO seen in spinal cord injury (SCI) and other trauma. Use of neuromuscular blockade does not appear to explain this risk. An unidentified humoral response mechanism may underlie the development of HO in these cases. Certain individuals may be genetically predisposed to develop HO. CONCLUSION: Increased awareness of this relatively new entity may assist early diagnosis, medical treatment, and eventually direct rehabilitation. Investigation of the pathogenesis of different types of HO may provide clues to the prevention and treatment of HO in individuals with SCI and other central nervous system trauma.