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Ǵм Yeungnam Univ J Med 2018;35(1):130-134


Preoperative arterial embolization of heterotopic ossification around the hip joint

Jin Hyeok Kim1, Chankue Park1, Seung Min Son2, Won Chul Shin2, Joo Yeon Jang1, Hee Seok Jeong1, In Sook Lee3, Tae Young Moon1
Departments of 1Radiology and 2Orthopedic Surgery, Pusan National University Yangsan Hospital, Yangsan;
3Department of Radiology, Pusan National University Hospital, Busan, Korea
Corresponding Author: Chankue Park, Department of Radiology, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea
Tel: +82-55-360-1840, Fax: +82-55-360-1848
E-mail: chankue.park@gmail.com

Received: April 18, 2018, Revised: May 18, 2018 Accepted: May 21, 2018


Heterotopic ossification (HO) around the hip joint is not uncommon following neurological injury. Often, surgical treatment is performed in patients with restricted motion and/or refractory pain due to grade III or IV HO according to Brooker classification. The major complication that occurs as a result of surgical HO removal is perioperative bleeding due to hyper-vascularization of the lesion. Here, we report a case of preoperative embolization in a 51-year-old male patient presenting with restricted bilateral hip range of motion (ROM) due to HO following a spinal cord injury. In the right hip without preoperative arterial embolization, massive bleeding occurred during surgical removal of HO. Thus, the patient received a transfusion postoperatively due to decreased serum hemoglobin levels. For surgery of the left hip, preoperative embolization of the arteries supplying HO was performed. Surgical treatment was completed without bleeding complications, and the patient recovered without a postoperative transfusion. This case highlights that, while completing surgical removal for ROM improvements, orthopedic surgeons should consider preoperative arterial embolization in patients with hip HO.

Key Words: Keywords: Hip; Heterotopic ossification; Arterial embolization; Gelatin sponge