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J Korean Soc Ther Radiol Oncol. 2007 Dec;25(4):206-212. English. Original Article.
Kim HJ , Kim JH , Kim K , Choi JY , Chung MS , Kim IH .
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. ihkim@snu.ac.kr
Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Abstract

PURPOSE: Heterotopic ossification is a well-known postoperative and post-traumatic complication of the elbow. We reviewed the treatment outcome for the use of low-dose radiation after surgical intervention of the elbow to prevent recurrence of heterotopic ossification (HO). MATERIALS AND METHODS: Forty-five patients with HO underwent surgical intervention and postoperative radiotherapy of the elbow. The median age of the patients was 29 years (16~75 years), and 27 of the patients were men and 18 were women. The occurrence of HO was mainly due to surgery after fracture (24/45) and traumatic injury (21/45). Limitation of the range of motion (ROM) was the most common symptom of the patients. Thirty-four patients received postoperative radiotherapy with a dose of 8 Gy in 2 fractions; 5 patients received a dose of 10 Gy in 5 fractions and 6 patients received a dose of 7 Gy in 1 fraction. Postoperative radiotherapy was given on the first two postoperative days for most of the patients. Sixteen patients were not given anti-inflammatory medication and 29 patients were given NSAIDs for 1~8 months. RESULTS: After a median follow-up period of 18 months (range 6~72 months), 41 patients showed clinical improvement and two patients did not show improvement. Assessment of the ROM showed a mean improvement from 0~135degrees to 60~145degrees (p=0.028), and assessment of the functional outcome according to MEPI was from (15~95) to (80~100) (p<0.0001). Two of the 34 patients that were followed-up with radiography had mild radiological recurrence of heterotopic ossification. No complications were observed after the radiotherapy. CONCLUSION: These results suggested that low-dose radiation administered after surgical intervention is safe and effective to prevent the recurrence of HO in the elbow.

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