| Keywords [eng] |
Heterotopic Ossification, Acquired HO ,Fibrodysplasia Ossificans Progressiva (FOP), Diagnostic tools, Treatment Strategies, Surgical Excision, Physical Therapy, Pharmacological Prophylaxis, Innovative Therapies |
| Abstract [eng] |
The treatment of heterotopic ossification (HO), a pathological disease in which ectopic bone forms in soft tissues, is examined in this thesis. HO can be acquired, for example after burns, trauma, surgery, or brain injury, or it can be caused by genetic disorders such as progressive osseous heteroplasia (POH) or fibrodysplasia ossificans progressiva (FOP). Examining new and existing HO therapy modalities is the goal of this thesis. It focuses on pharmacological, physiotherapeutic, surgical, and experimental techniques. Identifying clinical difficulties, assessing current treatment outcomes, and demonstrating future advancements based on molecular pathway blockage. A comprehensive literature review was conducted to collect and examine information on the epidemiology, pathophysiology, diagnosis, and management of acquired and genetic HO. This involved a critical assessment of current advancements in targeted molecular therapy, case reports, and clinical research. Since these are important mechanisms for ectopic bone formation, special attention was paid to signaling pathways like BMP/Smad, RAR, Hedgehog, Wnt/β-catenin, EndMT, and mTOR/HIF-1α. The results demonstrate that although surgical excision is still the most effective treatment for mature HO, there are risks involved, including infection, bleeding, and even recurrence. Physiotherapy has a helpful but discussed role. Aggressive movement may exacerbate the ossification, whereas mild, painless mobilization is helpful. In high-risk patients, pharmacologic prophylaxis with NSAIDs, bisphosphonates, or radiation has been shown to be successful in lowering the risk of HO. Furthermore, promising new treatments specifically target molecular pathways involved in inflammation and bone formation, have shown to be helpful as well. In conclusion, treating HO requires a customized, multidisciplinary strategy. Although conservative and surgical approaches are currently the norm, customized therapies that act at the molecular level to stop or reverse ectopic bone growth are the way of the future. |
