{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:15:10Z","timestamp":1783509310983,"version":"3.55.0"},"reference-count":30,"publisher":"MDPI AG","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    The formation of heterotopic ossification (HO) is a common complication after transosseous partial foot amputation. Development of HO in weightbearing and\/or superficial areas can lead to increased pressures, which increases the likelihood of wound formation and pain. Current treatment modalities for HO of the foot include mechanical off-loading and surgical resection; however, prophylactic measures such as nonsteroidal anti-inflammatory drugs, bisphosphonates, and other medical therapies have been attempted previously with mixed efficacy. Radiation therapy is another prophylactic method that may be used for the prevention of HO in patients after transosseous partial foot amputation.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    The present case series evaluated ten patients who underwent transosseous partial foot amputation for HO resection immediately followed by single low-dose radiation treatment. All of the patients received radiation between 700 and 800 cGy, with 6 MV photons directed at the area of concern within 48 hours of surgery.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Postoperatively, 10% of patients had HO recurrence, 80% remained fully weightbearing, 90% went on to primarily heal their surgical incisions, and 80% had postoperative pain relief; however, 30% went on to below-the-knee amputation due to chronic pain and\/or infectious or nonfunctional pathology.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Radiation therapy is a relatively available and safe modality for the prevention of HO that may be used prophylactically in cases of high suspicion of or known HO formation of the foot.\n                  <\/jats:p>","DOI":"10.7547\/22-055","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T10:11:27Z","timestamp":1737972687000},"source":"Crossref","is-referenced-by-count":0,"title":["Prophylactic Irradiation for the Prevention of Heterotopic Ossification After Foot Amputation: A Case Series"],"prefix":"10.3390","volume":"114","author":[{"given":"Amber M.","family":"Kavanagh","sequence":"first","affiliation":[{"name":"MedStar Health Podiatric Surgery Residency Program, Washington, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Miller","sequence":"additional","affiliation":[{"name":"MedStar Georgetown University Hospital Foot and Ankle Research Fellowship, Washington, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"McKeon","sequence":"additional","affiliation":[{"name":"MedStar Health Podiatric Surgery Residency Program, Washington, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayson N.","family":"Atves","sequence":"additional","affiliation":[{"name":"MedStar Health Podiatric Surgery Residency Program, Washington, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Steinberg","sequence":"additional","affiliation":[{"name":"MedStar Health Podiatric Surgery Residency Program, Washington, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Attinger","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","series-title":"J Bone Joint Surg Am","first-page":"1101","article-title":"Heterotopic ossification: basic-science principles and clinical correlates","volume":"97","author":"Ranganathan K","year":"2015","unstructured":"Ranganathan K, Loder S, Agarwal S, et al: Heterotopic ossification: basic-science principles and clinical correlates. J Bone Joint Surg Am 97: 1101, 2015."},{"key":"B2","series-title":"J Nucl Med","first-page":"346","article-title":"Heterotopic ossification","volume":"43","author":"Shehab D","year":"2002","unstructured":"Shehab D, Elgazzar AH, Collier BD: Heterotopic ossification. J Nucl Med 43: 346, 2002."},{"key":"B3","series-title":"J Foot Ankle Surg","first-page":"714","article-title":"Incidence and clinical significance of heterotopic ossification after partial ray resection","volume":"55","author":"Boffeli TJ","year":"2016","unstructured":"Boffeli TJ, Thompson JC, Waverly BJ, et al: Incidence and clinical significance of heterotopic ossification after partial ray resection. J Foot Ankle Surg 55: 714, 2016."},{"key":"B4","series-title":"J Bone Joint Surg Am","first-page":"1561","article-title":"Factors associated with bone regrowth following diabetes-related partial amputation of the foot","volume":"81","author":"Armstrong DG","year":"1999","unstructured":"Armstrong DG, Hadi S, Nguyen HC, et al: Factors associated with bone regrowth following diabetes-related partial amputation of the foot. J Bone Joint Surg Am 81: 1561, 1999."},{"key":"B5","series-title":"J Am Acad Orthop Surg","first-page":"409","article-title":"Heterotopic ossification after hip and knee arthroplasty: risk factors, prevention, and treatment","volume":"10","author":"Iorio R","year":"2002","unstructured":"Iorio R, Healy WL: Heterotopic ossification after hip and knee arthroplasty: risk factors, prevention, and treatment. J Am Acad Orthop Surg 10: 409, 2002."},{"key":"B6","series-title":"J Bone Joint Surg Br","first-page":"36","article-title":"Observations on the induction of bone in soft tissues","volume":"57","author":"Chalmers J","year":"1975","unstructured":"Chalmers J, Gray DH, Rush J: Observations on the induction of bone in soft tissues. J Bone Joint Surg Br 57: 36, 1975."},{"key":"B7","series-title":"Bone Joint Res","first-page":"51","article-title":"Heterotopic ossification after central nervous system trauma: a current review","volume":"2","author":"Sullivan MP","year":"2013","unstructured":"Sullivan MP, Torres SJ, Mehta S, et al: Heterotopic ossification after central nervous system trauma: a current review. Bone Joint Res 2: 51, 2013."},{"key":"B8","series-title":"J Bone Joint Surg Br","first-page":"1617","article-title":"Heterotopic ossification after the use of commercially available recombinant human bone morphogenetic proteins in four patients","volume":"90","author":"Axelrad TW","year":"2008","unstructured":"Axelrad TW, Steen B, Lowenberg DW, et al: Heterotopic ossification after the use of commercially available recombinant human bone morphogenetic proteins in four patients. J Bone Joint Surg Br 90: 1617, 2008."},{"key":"B9","series-title":"Bone","first-page":"115765","article-title":"A review of the biomarkers and in vivo models for the diagnosis and treatment of heterotopic ossification following blast and trauma-induced injuries","volume":"143","author":"Kazezian Z","year":"2021","unstructured":"Kazezian Z, Bull AMJ: A review of the biomarkers and in vivo models for the diagnosis and treatment of heterotopic ossification following blast and trauma-induced injuries. Bone 143: 115765, 2021."},{"key":"B10","series-title":"J Foot Ankle Surg","first-page":"345","article-title":"Radiation therapy for recurrent heterotopic ossification prophylaxis after partial metatarsal amputation","volume":"54","author":"Boffeli TJ","year":"2015","unstructured":"Boffeli TJ, Pfannenstein RR, Thompson JC: Radiation therapy for recurrent heterotopic ossification prophylaxis after partial metatarsal amputation. J Foot Ankle Surg 54: 345, 2015."},{"key":"B11","series-title":"J Am Acad Orthop Surg","first-page":"689","article-title":"Heterotopic ossification following traumatic brain injury and spinal cord injury","volume":"17","author":"Cipriano CA","year":"2009","unstructured":"Cipriano CA, Pill SG, Keenan MA: Heterotopic ossification following traumatic brain injury and spinal cord injury. J Am Acad Orthop Surg 17: 689, 2009."},{"key":"B12","series-title":"J Orthop Surg Res","first-page":"12","article-title":"Prophylaxis of heterotopic ossification: an updated review","volume":"4","author":"Baird EO","year":"2009","unstructured":"Baird EO, Kang QK: Prophylaxis of heterotopic ossification: an updated review. J Orthop Surg Res 4: 12, 2009."},{"key":"B13","series-title":"J Am Acad Orthop Surg","first-page":"191","article-title":"Heterotopic ossification in the residual limbs of traumatic and combat-related amputees","volume":"14","author":"Potter BK","year":"2006","unstructured":"Potter BK, Burns TC, Lacap AP, et al: Heterotopic ossification in the residual limbs of traumatic and combat-related amputees. J Am Acad Orthop Surg 14: 191, 2006."},{"key":"B14","series-title":"Clin Orthop Relat Res","first-page":"231","article-title":"Osteogenesis by radioisotope labelled cell populations in implants of bone matrix under the influence of ionizing radiation","volume":"76","author":"Craven PL","year":"1971","unstructured":"Craven PL, Urist MR: Osteogenesis by radioisotope labelled cell populations in implants of bone matrix under the influence of ionizing radiation. Clin Orthop Relat Res 76: 231, 1971."},{"key":"B15","series-title":"Antiinflamm Antiallergy Agents Med Chem","first-page":"52","article-title":"Clinical pharmacology of non-steroidal anti-inflammatory drugs: a review","volume":"11","author":"Bacchi S","year":"2012","unstructured":"Bacchi S, Palumbo P, Sponta A, et al: Clinical pharmacology of non-steroidal anti-inflammatory drugs: a review. 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Int Orthop 30: 79, 2006."},{"key":"B23","series-title":"Radiother Oncol","first-page":"10","article-title":"Radiotherapy for the prophylaxis of heterotopic ossification: a systematic review and meta-analysis of published data","volume":"113","author":"Popovic M","year":"2014","unstructured":"Popovic M, Agarwal A, Zhang L, et al: Radiotherapy for the prophylaxis of heterotopic ossification: a systematic review and meta-analysis of published data. Radiother Oncol 113: 10, 2014."},{"key":"B24","series-title":"Radiol Med","first-page":"463","article-title":"Heterotopic ossifications: role of radiotherapy as prophylactic treatment","volume":"123","author":"Ruo Redda MG","year":"2018","unstructured":"Ruo Redda MG, De Colle C, Bianco L, et al: Heterotopic ossifications: role of radiotherapy as prophylactic treatment. 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Int J Radiat Oncol Biol Phys 39: 961, 1997."},{"key":"B28","series-title":"J Arthroplasty","first-page":"854","article-title":"The suppression of heterotopic ossifications radiation versus NSAID therapy: a prospective study","volume":"13","author":"Sell S","year":"1998","unstructured":"Sell S, Willms R, Jany R, et al: The suppression of heterotopic ossifications radiation versus NSAID therapy: a prospective study. J Arthroplasty 13: 854, 1998."},{"key":"B29","series-title":"Clin Orthop Relat Res","first-page":"2984","article-title":"Targeted muscle reinnervation: a novel approach to postamputation neuroma pain","volume":"472","author":"Souza JM","year":"2014","unstructured":"Souza JM, Cheesborough JE, Ko JH, et al: Targeted muscle reinnervation: a novel approach to postamputation neuroma pain. 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