• OBJECTIVES
    • To examine the efficacy and safety of radiotherapy for the prevention of heterotopic ossification (HO) about the elbow.
  • DESIGN
    • Retrospective chart review.
  • SETTING
    • Level 1 trauma center.
  • PATIENTS/PARTICIPANTS
    • Two hundred and twenty-nine patients who received prophylactic radiotherapy (XRT) over a 15-year period were identified. Patients were included if they received XRT to the elbow joint and had at least 12 weeks of follow-up after XRT. Fifty-four patients were ultimately included.
  • INTERVENTION
    • All patients were treated with a single dose of 7 Gy. Ninety-eight percentage of patients received XRT within 24 hours after surgery, and all patients received XRT within 72 hours after surgery.
  • MAIN OUTCOMES MEASUREMENTS
    • The primary study measures evaluated were the presence or absence of clinically symptomatic HO and the presence of radiographic HO after XRT to the elbow joint.
  • RESULTS
    • Eighteen patients were treated with XRT after a traumatic injury requiring surgery (primary prophylaxis), and 36 were treated with XRT after excision surgery to remove HO which had already formed (secondary prophylaxis). In the primary cohort, 16.7% developed symptomatic HO after XRT and 11.1% required surgery to resect the heterotopic bone. In the secondary cohort, 11.1% developed symptomatic HO after surgery and XRT and 5.5% required resection surgery. No secondary malignancies were identified.
  • CONCLUSIONS
    • Our findings suggest that XRT for elbow HO may be safe and effective for both primary and secondary HO. XRT for HO was not shown to be associated with radiation-induced sarcoma in this series, at least in the short term. Further study in a large patient population with extended follow-up is required to better characterize populations at high risk for development of HO and secondary malignancy.
  • LEVEL OF EVIDENCE
    • Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.