@article{00b0ce5a66f644b0a9c5a37eac8e2a72,
title = "Developing a combat-relevant translatable large animal model of heterotopic ossification",
abstract = "Heterotopic ossification (HO) refers to ectopic bone formation, typically in residual limbs following trauma and injury. A review of injuries from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) indicated that approximately 70% of war wounds involved the musculoskeletal system, largely in part from the use of improvised explosive devices (IED) and rocket-propelled grenades (RPG). HO is reported to occur in approximately 63%–65% of wounded warriors from OIF and OEF. Symptomatic HO may delay rehabilitation regimens since it often requires modifications to prosthetic limb componentry and socket size. There is limited evidence indicating a mechanism for preventing HO. This may be due to inadequate models, which do not produce HO bone structure that is morphologically similar to HO samples obtained from wounded warfighters injured in theatre. We hypothesized that using a high-power blast of air (shockwave) and simulated battlefield trauma (i.e. bone damage, tourniquet, bacteria, negative pressure wound therapy) in a large animal model, HO would form and have similar morphology to ectopic bone observed in clinical samples. Initial radiographic and micro-computed tomography (CT) data demonstrated ectopic bone growth in sheep 24 weeks post-procedure. Advanced histological and backscatter electron (BSE) analyses showed that 5 out of 8 (63%) sheep produced HO with similar morphology to clinical samples. We conclude that not all ectopic bone observed by radiograph or micro-CT in animal models is HO. Advanced histological and BSE analyses may improve confirmation of HO presence and morphology, which we demonstrated can be produced in a large animal model.",
keywords = "Ectopic bone, Heterotopic ossification, Histology, Large animal model, Traumatic HO",
author = "Epperson, {Richard T.} and Isaacson, {Brad M.} and Rothberg, {David L.} and Olsen, {Raymond E.} and Brooke Kawaguchi and Maxwell, {John M.} and Mary Dickerson and Pasquina, {Paul F.} and John Shero and Williams, {Dustin L.}",
note = "Funding Information: This material is the result of work supported by the Department of Defense , Award # W81XWH-16-2-0037 , the Center for Rehabilitation Sciences Research Award # HU0001-15-2-0003 , and a donation from the Wounded Warrior Amputee Softball Team Association . Work was also performed with resources and the use of facilities at the George E. Wahlen Department of Veterans Affairs. The contents do not represent the views of the U.S. Department of Veterans Affairs, the United States Government, the Uniformed Services University, or the Department of Defense. The authors thank Nicholas Taylor, Mattias Nielsen, Li Cadenas, Jeff Rogers, Ryan Rasmussen and the University of Utah Comparative Medicine Center staff for their technical support. The authors also thank Martin Engineering for donating the air cannon systems for use in this study, as well as Thaine Morris for his expertise with pyrotechnics and pressurized air systems selection. Funding Information: This material is the result of work supported by the Department of Defense, Award #W81XWH-16-2-0037, the Center for Rehabilitation Sciences Research Award #HU0001-15-2-0003, and a donation from the Wounded Warrior Amputee Softball Team Association. Work was also performed with resources and the use of facilities at the George E. Wahlen Department of Veterans Affairs. The contents do not represent the views of the U.S. Department of Veterans Affairs, the United States Government, the Uniformed Services University, or the Department of Defense. The authors thank Nicholas Taylor, Mattias Nielsen, Li Cadenas, Jeff Rogers, Ryan Rasmussen and the University of Utah Comparative Medicine Center staff for their technical support. The authors also thank Martin Engineering for donating the air cannon systems for use in this study, as well as Thaine Morris for his expertise with pyrotechnics and pressurized air systems selection. Publisher Copyright: {\textcopyright} 2021",
year = "2021",
month = dec,
doi = "10.1016/j.bonr.2021.101127",
language = "English",
volume = "15",
journal = "Bone Reports",
issn = "2352-1872",
}