{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T08:25:31Z","timestamp":1789979131269,"version":"4.0.1"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2016,4,20]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Heterotopic ossification (HO) is a debilitating condition that occurs following traumatic injury and may restrict range of motion and delay rehabilitation. The timing and efficacy of surgical resection have varied widely, and there is a gap in knowledge between clinical predictors of HO recurrence and histological analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Thirty-three service members seen at Walter Reed National Military Medical Center for symptomatic HO were enrolled in an institutional review board-approved study. Participants took oxytetracycline on four scheduled days prior to HO resection to determine the mineral apposition rate (bone growth rate).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Detailed histological analyses included scanning electron microscopy with backscattered electron imaging and light microscopy. Data indicated that the mineral apposition rate of trauma-induced HO was approximately 1.7 \u03bcm\/day at the time of operative intervention, which was 1.7 times higher than the rate in non-pathological human bone. The mineral apposition rate and postoperative alkaline phosphatase values were demonstrated to be positively and significantly related (\u03c1 = 0.509, p = 0.026, n = 19). When the analysis was limited to patients with no more than a two-year period from injury to excision (thereby removing outliers who had a longer time period than their counterparts) and traumatic brain injury and nonsteroidal anti-inflammatory drugs (known correlates with HO development) were controlled for in the statistical analysis, the mineral apposition rate and recurrence severity were significantly related (\u03c1 = \u22120.572, p = 0.041, n = 11).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Data demonstrated a link between benchtop research and bedside care, with the mineral apposition rate elevated in patients with HO and correlated with recurrence severity; however, a larger sample size and more clinical factors are needed to refine this model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level II<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.15.00895","type":"journal-article","created":{"date-parts":[[2016,4,20]],"date-time":"2016-04-20T14:04:20Z","timestamp":1461161060000},"page":"647-657","source":"Crossref","is-referenced-by-count":13,"title":["Link Between Clinical Predictors of Heterotopic Ossification and Histological Analysis in Combat-Injured Service Members"],"prefix":"10.2106","volume":"98","author":[{"given":"B.M.","family":"Isaacson","sequence":"first","affiliation":[{"name":"The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland"},{"name":"The Center for Rehabilitation Sciences Research, Department of Physical Medicine & Rehabilitation, Uniformed Services University of Health Sciences, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.K.","family":"Potter","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedics (B.K.P.) and Rehabilitation (P.F.P.), Walter Reed National Military Medical Center, Bethesda, Maryland"},{"name":"Department of Surgery, Uniformed Services University of Health Sciences, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.D.","family":"Bloebaum","sequence":"additional","affiliation":[{"name":"Bone & Joint Research Laboratory, Department of Veterans Affairs, Salt Lake City, Utah"},{"name":"Departments of Bioengineering and Biology, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.T.","family":"Epperson","sequence":"additional","affiliation":[{"name":"Bone & Joint Research Laboratory, Department of Veterans Affairs, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.S.","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Bone & Joint Research Laboratory, Department of Veterans Affairs, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.M.","family":"Swanson","sequence":"additional","affiliation":[{"name":"The Center for Rehabilitation Sciences Research, Department of Physical Medicine & Rehabilitation, Uniformed Services University of Health Sciences, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.F.","family":"Pasquina","sequence":"additional","affiliation":[{"name":"The Center for Rehabilitation Sciences Research, Department of Physical Medicine & Rehabilitation, Uniformed Services University of Health Sciences, Bethesda, Maryland"},{"name":"Departments of Orthopaedics (B.K.P.) and Rehabilitation (P.F.P.), Walter Reed National Military Medical Center, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"9","key":"bib1-20230714","doi-asserted-by":"crossref","first-page":"2968","DOI":"10.1007\/s10439-010-0050-2","article-title":"Developing a quantitative measurement system for assessing heterotopic ossification and monitoring the bioelectric metrics from electrically induced osseointegration in the residual limb of service members","volume":"38","author":"Isaacson","year":"2010","journal-title":"Ann Biomed Eng."},{"issue":"1","key":"bib2-20230714","first-page":"54","article-title":"Heterotopic ossification in wartime wounds","volume":"19","author":"Forsberg","year":"2010","journal-title":"J Surg Orthop Adv."},{"issue":"3","key":"bib3-20230714","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1097\/PHM.0b013e3181c5657c","article-title":"Heterotopic ossification in the residual lower limb in an adult nontraumatic amputee patient","volume":"89","author":"Atkinson","year":"2010","journal-title":"Am J Phys Med Rehabil."},{"issue":"10","key":"bib4-20230714","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s00256-005-0958-z","article-title":"Heterotopic ossification: a review","volume":"34","author":"McCarthy","year":"2005","journal-title":"Skeletal Radiol."},{"issue":"10 Spec No.","key":"bib5-20230714","doi-asserted-by":"crossref","first-page":"S191","DOI":"10.5435\/00124635-200600001-00042","article-title":"Heterotopic ossification in the residual limbs of traumatic and combat-related amputees","volume":"14","author":"Potter","year":"2006","journal-title":"J Am Acad Orthop Surg."},{"issue":"3","key":"bib6-20230714","doi-asserted-by":"crossref","first-page":"476","DOI":"10.2106\/JBJS.F.00412","article-title":"Heterotopic ossification following traumatic and combat-related amputations. 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