Heterotopic Ossification: Symptoms, Causes, and Treatment Options

What Is Heterotopic Ossification (HO)?

HO is the formation of mature lamellar bone in soft tissues (muscles, tendons, fascia) where bone does not normally exist. It commonly follows trauma, surgery, burns, or neurological injury.

Common Symptoms

• Pain and tenderness near the affected site
• Swelling and warmth
• Stiffness or reduced range of motion
• Palpable hard mass
• Nerve compression symptoms (numbness, tingling, weakness)

Small, asymptomatic HO may be discovered incidentally and require no treatment.

Typical Causes

• Orthopedic surgery (hip arthroplasty, fracture fixation)
• Severe burns
• Traumatic brain or spinal cord injury
• Genetic conditions (e.g., fibrodysplasia ossificans progressiva)

Management

• Observation for asymptomatic, non-progressive lesions.
• NSAIDs (indomethacin) or radiation prophylaxis post-surgery.
• Physical therapy to maintain mobility.
• Surgical excision after maturation (typically 6–12 months) if causing functional impairment or neurovascular compromise.