Heterotopic ossification after hip surgery in cerebral palsy

Abstract Heterotopic ossification is a post-surgery compli- cation occasionally observed in patients with in- fantile cerebral palsy. In the majority of the cases such lesions are found at the hip after surgery on the skeleton and the soft tissues. At our Institute in the last five years, this com- plication has been observed four times, in 39 pa- tients, who underwent mainly soft tissue releas- es because of flexion and adduction contracture of the hip, In these cases, as in a further patient with myelomeningocele, the periarticular heterotopic ossification appeared in the hip after tenotomy of the ilio-psoas at the lesser tronchater associat- ed to other surgical procedures. Conversely, no cases of ossification have been found after tenotomy of the adductors or the gracilis or selective tenotomy of the psoas at the pelvic brim. The exact causes of this complication are still un- clear, but after an analysis of the literature and patient history it can be hypothesised that it may be related to the surgical procedures carried out.