{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T11:45:25Z","timestamp":1778759125370,"version":"3.51.4"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"11-12","funder":[{"DOI":"10.13039\/100003896","name":"Henry M. Jackson Foundation","doi-asserted-by":"publisher","award":["HU00012020062"],"award-info":[{"award-number":["HU00012020062"]}],"id":[{"id":"10.13039\/100003896","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Traumatic hip and pelvic level amputations are uncommon but devastating injuries and associated with numerous complications that can significantly affect quality of life for these patients. While heterotopic ossification (HO) formation has been reported at rates of up to 90% following traumatic, combat-related amputations, previous studies included few patients with more proximal hip and pelvic level amputations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective review of the Military Health System medical record and identified patients with both traumatic and disease-related hip- and pelvic-level amputations performed between 2001 and 2017. We reviewed the most recent pelvis radiograph at least 3 months following amputation to determine bony resection level and the association between HO formation and reason for amputation (trauma versus disease related).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 93 patients with post-amputation pelvis radiographs available, 66% (n\u2009=\u200961) had hip-level amputations and 34% (n\u2009=\u200932) had a hemipelvectomy. The median duration from the initial injury or surgery to the most recent radiograph was 393\u2009days (interquartile range, 73\u20131,094). HO occurred in 75% of patients. Amputation secondary to trauma was a significant predictor of HO formation (\u03c72\u2009=\u200924.58; P\u2009&amp;lt;\u2009.0001); however, there was no apparent relationship between the severity of HO and traumatic versus non-traumatic etiology (\u03c72\u2009=\u20092.92; P\u2009=\u2009.09).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Amputations at the hip were more common than pelvic-level amputations in this study population, and three-fourths of hip- and pelvic-level amputation patients had radiographic evidence of HO. The rate of HO formation following blast injuries and other trauma was significantly higher compared with patients with non-traumatic amputations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usad129","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T22:36:06Z","timestamp":1684535766000},"page":"e3477-e3481","source":"Crossref","is-referenced-by-count":8,"title":["Heterotopic Ossification Formation in Military Beneficiaries Following Hip- and Pelvic-Level Amputations"],"prefix":"10.1093","volume":"188","author":[{"given":"Kaitlin S","family":"Porter","sequence":"first","affiliation":[{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8871-4726","authenticated-orcid":false,"given":"Colin J","family":"Harrington","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Walter Reed National Military Medical Center , Bethesda, MD 20889, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aline","family":"Babikian","sequence":"additional","affiliation":[{"name":"Department of Radiology, Walter Reed National Military Medical Center , Bethesda, MD 20889, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Heltzel","sequence":"additional","affiliation":[{"name":"Department of Radiology, Walter Reed National Military Medical Center , Bethesda, MD 20889, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin K","family":"Potter","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"Department of Orthopaedic Surgery, Walter Reed National Military Medical Center , Bethesda, MD 20889, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas G","family":"Smith","sequence":"additional","affiliation":[{"name":"The Center for Rehabilitation Sciences Research, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"Department of Rehabilitation, Walter Reed National Military Medical Center , Bethesda, MD 20889, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul F","family":"Pasquina","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"The Center for Rehabilitation Sciences Research, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"Department of Rehabilitation, Walter Reed National Military Medical Center , Bethesda, MD 20889, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,5,11]]},"reference":[{"issue":"3","key":"2023110723501602300_R1","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1007\/s12178-015-9288-5","article-title":"Blurred front lines: triage and initial management of blast injuries","volume":"8","author":"Balazs","year":"2015","journal-title":"Curr Rev Musculoskelet Med"},{"issue":"9","key":"2023110723501602300_R2","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1097\/00005131-200410000-00002","article-title":"Biomechanical comparison of sacroiliac screw techniques for unstable pelvic ring fractures","volume":"18","author":"van Zwienen","year":"2004","journal-title":"J Orthop Trauma"},{"issue":"12","key":"2023110723501602300_R3","doi-asserted-by":"publisher","first-page":"e493","DOI":"10.1097\/BOT.0000000000000398","article-title":"Combat-related 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