Robert Teasell MD FRCPC, Pavlina Faltynek MSc, Shannon Janzen MSc, Caitlin Cassidy MD, Magdalena Mirkowski MSc MScOT OT Reg.(Ont.), Shawn Marshall MD FRCPC, Nora Cullen MD FRCPC
Heterotopic ossification (HO) is the formation of pathologic bone within soft tissues, often muscle tissues, where bone formation does not usually occur (Watanabe & Sant 2001). The incidence of HO in patients with traumatic brain injury (TBI) has been reported to range from 11% to 77% but is clinically relevant in 10-20% (Dizdar et al. 2013; Garland et al. 1980; Rogers 1988; Sarafis et al. 1999; Sazbon et al. 1981; Zychowicz 2013). Risk factors include skeletal trauma, spasticity, diffuse axonal injury, mechanical ventilation, prolonged immobilization, and injury severity (Moreta & De los Mozos 2014). HO is often quite painful and limits joint mobility; the restricted joint range of motion may exacerbate disability and impede progress towards desired rehabilitation goals.