When do you treat heterotopic ossification with radiation pre-operatively?

Can pre-op radiation be delivered more than 24 hours before surgery?

No — this is not recommended and is generally ineffective.

Why timing matters (biologic rationale):

HO formation is driven by pluripotent mesenchymal progenitor cells that are recruited and activated by:

• Initial trauma
• Surgical manipu...

When dealing with trauma patients, you have no choice but to treat postoperatively. Ideally, very shortly after surgery. I've always considered the 3-day window to be a convenience for Radiation Oncologists so that we don't have to come in on the weekend for a patient having surgery on a Friday. Wou...

There is a paucity of facts regarding pre-op XRT by any interval, but the “more than” 24 hours occurs with a consult on Wednesday OR on Monday.

The goal is joint function and pain prevention.

I had one case done on a Friday with 8 Gy; OR Monday. Followed up with me for 3 years with success.

Pure ane...

We encourage orthopedic surgeons to refer patients well in advance to planned surgery for consultation, at which time we prebook CT simulation for the AM after surgery (same day is difficult if patients are in pain, confused from anesthesia, and if OR runs late, transportation issues etc.) and prebo...

All of the points that have been described above are excellent, and especially the comments that. Dr. @Dr. First Last provided

We used to do postoperative on a routine basis, but over the past 10 years, moved to a preoperative setting.

Our processes include having the patient visit with the surgeon ...