Trauma-induced heterotopic bone formation and the role of the immune system: A review

Casey T. Kraft, Shailesh Agarwal, Kavitha Ranganathan, Victor W. Wong, Shawn Loder, John Li, Matthew J. Delano, Benjamin Levi*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

72 Scopus citations


Extremity trauma, spinal cord injuries, head injuries, and burn injuries place patients at high risk of pathologic extraskeletal bone formation. This heterotopic bone causes severe pain, deformities, and joint contractures. The immune system has been increasingly implicated in this debilitating condition. This reviewsummarizes the various roles immune cells and inflammation play in the formation of ectopic bone and highlights potential areas of future investigation and treatment. Cell types in both the innate and adaptive immune system such as neutrophils, macrophages, mast cells, B cells, and T cells have all been implicated as having a role in ectopic bone formation through various mechanisms. Many of these cell types are promising areas of therapeutic investigation for potential treatment. The immune system has also been known to also influence osteoclastogenesis, which is heavily involved in ectopic bone formation. Chronic inflammation is also known to have an inhibitory role in the formation of ectopic bone, whereas acute inflammation is necessary for ectopic bone formation. J Trauma Acute Care Surg. 2016;80: 156-165.

Original languageEnglish
Pages (from-to)156-165
Number of pages10
JournalJournal of Trauma and Acute Care Surgery
Issue number1
StatePublished - 2016
Externally publishedYes


  • Ectopic bone
  • Fibrodysplasia ossificans progressive
  • Heterotopic ossification
  • Immune system
  • Macrophages


Dive into the research topics of 'Trauma-induced heterotopic bone formation and the role of the immune system: A review'. Together they form a unique fingerprint.

Cite this