Evidence map›Paper›PMID 41727788›Full record

ArticleOrthopaedic journal of sports medicine2026

Heterotopic Ossification After Multiligament Knee Injury Is Associated With Knee-Spanning External Fixation and Central Nervous System Trauma.

Ekrem M Ayhan, Sarah J Levitt, Meghana Nair, Nancy Park, Jay Moran, Lee Katz, Annie Wang, Fangyong Li, Zhiqian Song, Wasif Islam and 1 more

Abstract read
In one paragraph

Article in Orthopaedic journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Ekrem M AyhanDepartment of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.ORCID https://orcid.org/0009-0001-6923-3449
Sarah J LevittDepartment of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.
Meghana NairDepartment of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.ORCID https://orcid.org/0009-0007-8427-3397
Nancy ParkDepartment of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.
Jay MoranDepartment of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.ORCID https://orcid.org/0000-0001-6247-3047
Lee KatzDepartment of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.
Annie WangDepartment of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.
Fangyong LiYale Center for Analytical Sciences, Yale School of Public Health, New Haven, Connecticut, USA.
Zhiqian SongYale Center for Analytical Sciences, Yale School of Public Health, New Haven, Connecticut, USA.ORCID https://orcid.org/0009-0009-4083-0723
Wasif IslamDepartment of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.
Michael J MedveckyDepartment of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA.ORCID https://orcid.org/0000-0003-1481-3232

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Heterotopic ossification (HO) may occur after multiligament knee injuries (MLKIs), with the potential to cause significant functional deficits. However, risk factors for HO after MLKI are not well understood. Purpose: To identify the incidence and risk factors for HO after MLKI. Study Design: Case-control study; Level of evidence, 3. Methods: Patients were included if they had undergone treatment for an MLKI by a single surgeon at a level 1 trauma center between 2001 and 2023, with radiographs at the time of injury and at a minimum 6-month follow-up. All data were obtained from electronic medical records. Two senior musculoskeletal radiologists reviewed all cases for the presence of HO in the most recent radiographs, using the initial radiographs obtained at the time of injury for comparison. Patients were grouped by whether they had developed HO after MLKI. Univariable analyses were performed to compare patient, injury, and treatment characteristics between groups. Odds ratios (ORs) for HO were assessed by multivariable logistic regression, adjusted for ligament injury classification, mechanism of injury, documented dislocation, central nervous system (CNS) trauma, and knee-spanning external fixation (KSEF). Results: The studied cohort included 128 patients, of whom 28 were excluded due to insufficient follow-up. Of the remainder, 35 (35%) developed HO, with a mean follow-up of 35.17 months. In the univariable analysis, the HO group had significantly higher rates of documented dislocation, CNS trauma, and KSEF. In the multivariable analysis, KSEF (OR, 8.51; 95% CI, 21.81-31.717; Conclusion: The incidence of HO after MLKI was 35%. KSEF and CNS trauma were independently associated with HO. Recognition of these risk factors may help identify at-risk patients for closer monitoring and consideration of HO prophylaxis and should therefore be included in the decision-making strategy for KSEF versus early surgical treatment after MLKI.

Indexed as

external fixationheterotopic ossificationknee dislocationknee-spanning external fixatormultiligament knee injury

Identifiers

PMID41727788
PMCPMC12921146

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.