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KMID : 0361419940180040871
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Journal of Korean Academy of Rehabilitation Medicine
1994 Volume.18 No. 4 p.871 ~ p.875
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Dose Etidronate Disodium Inhibit Calcium Precipitation in Heterotopic Ossification? - Case study-
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Abstract
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Etidronate disodium (DidronelTM) is a synthetic diphosphonate analog of pyrophosphate, a naturally occuring inhititor of bone metabolism. Accepted indications for etidronate disodium therapy are symptomatic Paget's disease, heterotopic
ossification
and
hypercalcemia of malignancy. Etidronate disodium has been extensively studied in heterotopic ossification. The mechanism of action of etidronate disodium in the prevention of heterotopic ossification is not known. Chemical and in vitro studies
show
that
the drug adsorbs to hydroxyapatite crystals, therby inhibiting their growth and dissolution. But clinical research has not irrefutably proved or disproved the effectiveness of etidronate disodium in prevention of clinical heterotopic
ossification.
This paper presents two cases of heterotopic bone formation following neurologic insult. A 36-year-old male sustained traumatic brain injury secondary to a traffic accident. Three months postinjury, a physical examination reveale dlimitation of
range
motion of Rt elbow joint. The serum alkaline phosphatase was 335 IU/L. Roentgenograms were unremarkable. A bone scan revealed increased uptakes in the region of the Rt elbow and shoulder. Another patient C8 quadriplegic developed limitation of
range of
motion of Lt hip joint Etidronate disodium was used in a clinical trial to prevention of heterotopic ossification. Roentgeograms of the joints involved revealed formation of heterotopic bone after the drug was administered for 12 weeks. Further
prospective studies will be planned.
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KEYWORD
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