Le cartilage est un tissu conjonctif composé d’une seule sorte de cellule nommée chondrocytes. Ce tissu offre une fondation pour la formation des os. Les os longs se développent par l'ossification endochondral. Ce processus implique la coordination entre la prolifération, la différenciation et l'apoptose des chondrocytes, et résulte au remplacement du cartilage par l'os. Des anomalies au niveau du squelette et des défauts liés à l’âge tels que l’arthrose (OA) apparaissent lorsqu’il y a une perturbation dans l’équilibre du processus de développement. À ce jour, les mécanismes exacts contrôlant la fonction et le comportement des chondrocytes pendant la croissance et le développement du cartilage sont inconnus. Le récepteur activateur de la prolifération des peroxysomes (PPAR) gamma est un facteur de transcription impliqué dans l'homéostasie des lipides. Plus récemment, son implication a aussi été suggérée dans l'homéostasie osseuse. Cependant, le rôle de PPARγ in vivo dans la croissance et le développement du cartilage est inconnu. Donc, pour la première fois, cette étude examine le rôle spécifique de PPARγ in vivo dans la croissance et le développement du cartilage. Les souris utilisées pour l’étude avaient une délétion conditionnelle au cartilage du gène PPARγ. Ces dernières ont été générées en employant le système LoxP/Cre. Les analyses des souris ayant une délétion au PPARγ aux stades embryonnaire et adulte démontrent une réduction de la croissance des os longs, une diminution des dépôts de calcium dans l’os, de la densité osseuse et de la vascularisation, un délai dans l’ossification primaire et secondaire, une diminution cellulaire, une perte d’organisation colonnaire et une diminution des zones hypertrophiques, une désorganisation des plaques de croissance et des chondrocytes déformés. De plus, la prolifération et la différenciation des chondrocytes sont anormales. Les chondrocytes et les explants isolés du cartilage mutant démontrent une expression réduite du facteur de croissance endothélial vasculaire (VEGF)-A et des éléments de production de la matrice extracellulaire. Une augmentation de l’expression de la métalloprotéinase matricielle (MMP)-13 est aussi observée. Dans les souris âgées ayant une délétion au PPARγ, y est aussi noté des phénotypes qui ressemblent à ceux de l’OA tel que la dégradation du cartilage et l'inflammation de la membrane synoviale, ainsi qu’une augmentation de l’expression de MMP-13 et des néoépitopes générés par les MMPs. Nos résultats démontrent que le PPARγ est nécessaire pour le développement et l’homéostasie du squelette. PPARγ est un régulateur essentiel pour la physiologie du cartilage durant les stades de croissance, de développement et de vieillissement. / Cartilage, a connective tissue composed of chondrocytes, provides an intermediate template on which bones are formed. Long bones develop through endochondral ossification, involving coordination between chondrocyte proliferation, differentiation and apoptosis, resulting in bone replacing cartilage. Disturbances in this balance results in skeletal abnormalities, and age-related defects including osteoarthritis (OA). The exact mechanisms that control chondrocyte function and behaviour during growth and development are unknown. Peroxisome proliferator-activated receptor (PPAR) gamma, a transcription factor involved in lipid homeostasis, has recently been suggested to be involved in bone homeostasis. However, PPARγ’s role in cartilage growth and development in vivo is unknown. Therefore, for the first time, this study examines PPARγ’s specific in vivo role in cartilage growth and development using cartilage-specific PPARγ knockout (KO) mice. Conditional KO mice were generated using LoxP/Cre system. Histomorphometric analyses of embryonic and adult mutant mice demonstrate reduced long bone growth, calcium deposition, bone density, vascularity, and delayed primary and secondary ossification. Mutant growth plates are disorganized with abnormal chondrocyte shape, proliferation and differentiation, reduced cellularity, loss of columnar organization, and shorter hypertrophic zones. Isolated mutant chondrocytes and cartilage explants show decreased vascular endothelial growth factor (VEGF)-A and extracellular matrix (ECM) production product expression, and increased matrix metalloproteinase (MMP)-13 expression. Aged mutant mice exhibit accelerated OA-like phenotypes, and enhanced cartilage degradation, synovial inflammation, MMP-13 and MMP-generated neoepitope expression. Our data demonstrate that PPARγ is required for normal skeletal development and homeostasis, and is a critical regulator of cartilage health and physiology in early growth and development and aging.

In den letzten Jahren kam es in den deutschsprachigen Ländern zu einem sprunghaften Anstieg forensischer Altersschätzungen bei lebenden Personen. Der strafrechtlich relevante Hintergrund dieser Altersschätzungen besteht in der Beurteilung der Strafmündigkeit bzw. der Anwendbarkeit des Erwachsenenstrafrechts bei Beschuldigten ohne gesicherte Altersangaben. Entsprechend den Empfehlungen der "Arbeitsgemeinschaft für Forensische Altersdiagnostik" sollten für eine Altersschätzung im Strafverfahren eine körperliche Untersuchung mit Erfassung anthropometrischer Maße, der sexuellen Reifezeichen sowie möglicher altersrelevanter Entwicklungsstörungen, eine Röntgenuntersuchung der linken Hand sowie eine zahnärztliche Untersuchung mit Erhebung des Zahnstatus und Auswertung eines Orthopantomogramms eingesetzt werden. Zur Frage der Vollendung des 21. Lebensjahrs wird eine zusätzliche Röntgen- bzw. CT-Untersuchung der Schlüsselbeine empfohlen. Da für die Herkunftsregionen der zu untersuchenden Personen in der Regel keine forensisch verwertbaren Referenzstudien vorliegen, stellt sich die Frage, ob es gravierende Entwicklungsunterschiede bei verschiedenen ethnischen Gruppen gibt, die eine Anwendung der einschlägigen Altersstandards bei Angehörigen anderer ethnischer Gruppen als der Referenzpopulation verbieten würden. Die Skelettreifung wird in der betreffenden Altersgruppe offenbar nicht relevant von der ethnischen Zugehörigkeit der untersuchten Personen beeinflusst. Da für Röntgenuntersuchungen zur forensischen Altersdiagnostik keine medizinische Indikation besteht, ist für deren Durchführung eine richterliche Anordnung auf der Grundlage des § 81a der Strafprozessordnung erforderlich. Gesundheitliche Nachteile für die untersuchten Personen aufgrund der Strahlenexposition der eingesetzten Röntgenuntersuchungen sind nicht zu befürchten. Forschungsdesiderate bestehen in der Angabe von statistisch gesicherten Streubreiten bei kombinierter Anwendung der empfohlenen Methoden, in der Frage des Einflusses der Ethnie auf die sexuelle Reifeentwicklung, die Weisheitszahneruption und die Weisheitszahnmineralisation sowie in der Überprüfung nicht ionisierender bildgebender Verfahren für die forensische Altersdiagnostik. / In the German-speaking area, recent years have seen a rapid growth of the need for forensic age estimations. If, for example, no verified information on the age of a person suspected of a criminal offence is available, the need arises to determine whether the suspect has reached the age of criminal responsibility and general criminal law in force for adults is to be applied. According to recommendations of the Study Group on Forensic Age Diagnostics, age estimations carried out for the purpose of criminal proceedings should consist of a physical examination which also records anthropometric data, signs of sexual maturation and potential age-relevant developmental disorders, as well as of an X-ray of the left hand and a dental examination which records dentition status and evaluates an orthopantomogram. In addition, a radiological or computed tomographic examination of the clavicles is recommended to establish whether a person has attained 21 years of age. Since reference studies that could be used for forensic purposes are generally not available for the areas of origin of the persons under examination, the question arises whether there are significant developmental differences between various ethnic groups which would contradict the application of relevant age standards to members of ethnic groups other than the reference population. As far as the relevant age group is concerned, ethnic origin apparently exerts no significant influence on skeletal maturation. Since there is no medical indication for X-ray examinations carried out for forensic age estimations, a court order under Section 81a of the Code of Criminal Procedure is required in Germany to authorize the necessary examinations. There is no reason to fear that the amount of radiation a person is exposed to during the X-ray examinations will have a detrimental effect on his/her health. Future research will have to provide statistically sound data on the ranges of scatter for combined use of the recommended methods, quantify the impact of ethnicity on sexual maturation, the eruption and mineralization of third molars, as well as review the suitability of non-ionizing imaging methods for forensic age estimation purposes.

<p>In this thesis, occurrence of heterotopic ossification (HO) following total hip arthroplasty (THA) was studied. Preventive effects and complications with non-steroidal anti-inflammatory drugs (NSAIDs) were analyzed. Experimental investigations on bone formation were employed to gain insight to the mechanism of NSAIDs action on bone.</p><p>(I). Fifty-six patients with bilateral THAs were analyzed. We found a strong correlation between HO on the two sides. Incidence and grade of HO were higher in men than in women.</p><p>(II). Sixty-nine patients with bilateral THAs who had been treated with NSAIDs after one or both THAs were analyzed for HO. Widespread HO occurred in untreated THAs, but in none of the treated THAs.</p><p>(III). A consecutive series of THAs were analyzed for HO. No widespread HO occurred in patients treated with NSAIDs for 21 days. In contrast, widespread HO occurred in 23% of patients not treated.</p><p>(IV). A randomized, double-blind, prospective study on 144 patients was performed to determine the efficacy and minimum treatment time with Ibuprofen for prophylaxis of HO after THA. Treatment with Ibuprofen was effective for preventing HO and a treatment time of 8 days was sufficient.</p><p>(V). A ten-year follow-up examination was performed on the patients from study IV. Thirteen patients had been revised. All but one belonged to groups treated with Ibuprofen. However, the prosthetic survival time was not statistically different for patients treated with NSAIDs compared to the control group. Eighty-four more patients underwent radiographic examination10 years after THA. Nine loose prostheses were found. These were equally distributed between NSAIDs-treated and non-treated THAs. When combining complications (revisions and radiographic loosening) no significant effects could be verified.</p><p>(VI). Experimental induction of heterotopic new bone with demineralized allogeneic bone matrix (DABM) and with bone autografts, was used in rats to study effects of NSAIDs on new bone formation. Indomethacin inhibited net bone formation in DABMs and in orthotopic fractured bone. In contrast, a net mineral loss occurred in autografts, but neither mineral content nor ⁴⁵Ca incorporation was affected by Indomethacin treatment. The amount of bone formed per mg implanted DABM was linearly correlated to implant size.</p>

Displaced femoral neck fractures comprise more than a third of all hip fractures. There is controversy as to the optimal treatment. Despite attempts to improve the methods for internal fixation, complication rates have been almost unchanged: 20-40% non-union and late segmental collapse in another 10-20%. Internal fixation has been the preferred treatment in Scandinavia, whereas primary hemi- or total arthroplasty have been more prevalent in the rest of Europe and North America. In this study, patients 75 years or older, including those with mental impairment, were randomized to either internal fixation or cemented primary total hip arthroplasty (THA). A total of 146 hips in 143 patients were followed for two years. After one year 23% had died, and after two years 29%. Mortality was about the same in both groups. The accumulated mortality was pronounced among the mentally impaired patients. In the internal fixation group, 44% underwent further surgery. In the THA group, 18% dislocated. The dislocation rate was higher for the mentally impaired patients. The Harris hip scores were higher in the THA group, whereas pain was more common in the internal fixation group. The first 50 patients in each treatment group were studied concerning heterotopic ossification (HO), a well-known complication after THA. The incidence of HO in the THA group was similar to what is found after THA due to osteoarthritis. However, only 1/39 developed severe symptoms. A subgroup of 100 patients was included in a study concerning nutritional status and functional capacity using the Modified Norton scale, Katz index of ADL and a questionnaire measuring instrumental activities of daily living. The THA group fared better concerning weight change over time, locomotion and pain. The nutritional intervention did not show any measurable effects. All patients were followed until two years postoperatively and all fracturerelated hospital costs, including reoperations, were calculated. We found no difference in total costs between the treatment groups. Costs to the municipality were calculated comparing the baseline cost before surgery with the average cost per month during the first postoperative year. No difference was found between the treatment groups. On the basis of our results, we recommend arthroplasty for patients in this age group with normal mental function and high functional demands.

In this thesis, occurrence of heterotopic ossification (HO) following total hip arthroplasty (THA) was studied. Preventive effects and complications with non-steroidal anti-inflammatory drugs (NSAIDs) were analyzed. Experimental investigations on bone formation were employed to gain insight to the mechanism of NSAIDs action on bone. (I). Fifty-six patients with bilateral THAs were analyzed. We found a strong correlation between HO on the two sides. Incidence and grade of HO were higher in men than in women. (II). Sixty-nine patients with bilateral THAs who had been treated with NSAIDs after one or both THAs were analyzed for HO. Widespread HO occurred in untreated THAs, but in none of the treated THAs. (III). A consecutive series of THAs were analyzed for HO. No widespread HO occurred in patients treated with NSAIDs for 21 days. In contrast, widespread HO occurred in 23% of patients not treated. (IV). A randomized, double-blind, prospective study on 144 patients was performed to determine the efficacy and minimum treatment time with Ibuprofen for prophylaxis of HO after THA. Treatment with Ibuprofen was effective for preventing HO and a treatment time of 8 days was sufficient. (V). A ten-year follow-up examination was performed on the patients from study IV. Thirteen patients had been revised. All but one belonged to groups treated with Ibuprofen. However, the prosthetic survival time was not statistically different for patients treated with NSAIDs compared to the control group. Eighty-four more patients underwent radiographic examination10 years after THA. Nine loose prostheses were found. These were equally distributed between NSAIDs-treated and non-treated THAs. When combining complications (revisions and radiographic loosening) no significant effects could be verified. (VI). Experimental induction of heterotopic new bone with demineralized allogeneic bone matrix (DABM) and with bone autografts, was used in rats to study effects of NSAIDs on new bone formation. Indomethacin inhibited net bone formation in DABMs and in orthotopic fractured bone. In contrast, a net mineral loss occurred in autografts, but neither mineral content nor 45Ca incorporation was affected by Indomethacin treatment. The amount of bone formed per mg implanted DABM was linearly correlated to implant size.

La périostine est une protéine matricellulaire préférentiellement exprimée aux sites de contraintes mécaniques, notamment le périoste, et dans le stroma associé à de nombreux types de cancers. En premier lieu, nous nous sommes attachés à évaluer la pertinence de cette protéine en tant que biomarqueur du métabolisme osseux et de la réaction stromale dans les métastases osseuses. Nous avons développé le premier dosage ELISA de la périostine circulante chez la souris présentant des caractéristiques analytiques (spécificité, précision) conformes aux exigences réglementaires. Ce dosage nous a permis de préciser l'implication de la périostine dans le métabolisme osseux et les métastases osseuses de cancer du sein. Nos données in vitro et in vivo suggèrent que la périostine n'est pas un indice direct du remodelage osseux, contrairement aux marqueurs biologiques conventionnels, mais une composante de l'ossification primaire. Nous avons aussi montré dans les métastases osseuses d'origine mammaire que la périostine est surexprimée par les cellules stromales de la métastase, comme cela a pu être observé au niveau des tumeurs primaires. Enfin, nous avons confirmé par une approche bioinformatique la relation étroite entre périostine et réaction stromale dans la plupart des tumeurs chez l'Homme. La périostine et d'autres protéines conjointement exprimées pourraient donc constituer un panel de marqueurs biologiques de la progression tumorale, certains pouvant se révéler comme nouvelles cibles thérapeutiques en oncologie.

Cysteine rich with EGF-like domains 2 (Creld2) is a novel endoplasmic reticulum (ER) resident molecular chaperone that has been recently implicated in the ER stress signalling response (ERSS) and the unfolded protein response (UPR). Global transcriptomic data derived from in vivo mouse models of rare chondrodysplasias; Multiple Epiphyseal Dysplasia (MED Matn3 p.V194D) and Metaphyseal chondrodysplasia type Schmid (MCDS Col10a1 p.N617K), identified a significant upregulation in Creld2 expression in mutant chondrocytes. These chondrodysplasias share a common disease signature consisting of aberrant folding of a matrix component often as a result of inappropriate alignment of intramolecular disulphide bonds. This in turn culminates in toxic protein aggregation, intracellular retention mutant polypeptides and a classical ER stress response. The aim of this study was to further analyse the function of Creld2 in cartilage development and chondrodysplasias in which endochondral bone growth is perturbed. Protein disulphide isomerases (PDIAs) were amongst the most up-regulated genes in the MED and MCDS mouse models, consistent with the prolonged exposure of normally 'buried' cysteine residues. This led to the hypothesis that Creld2 was functioning as a novel PDI-like oxidoreductase to assist in the correct folding and maturation of aggregated misfolded polypeptide chains through REDOX regulated thiol disulphide exchange. A series of Creld2-CXXA substrate trapping mutants were generated in order to determine whether Creld2 possessed inherent isomerase activity. Here potential substrates interacting with Creld2 were 'trapped' as mixed disulphide intermediates, then isolated by immunoprecipitation and identified by mass spectrometry analysis. It was demonstrated that Creld2 possessed a catalytic active CXXC motif in its N-terminus that enabled the molecular chaperone to participate in REDOX regulated thiol disulphide exchange with at least 20 potential substrates including; laminin (alpha3,β3,γ2), thrombospondin 1, integrin alpha3 and type VI collagen. There was also numerous co-chaperones and foldases thought to be part of a specialised protein-protein interactome (PPI) for folding nascent polypeptides translocating the ER lumen. Moreover, co-immunoprecipitation experiments supported a protein-protein interaction between Creld2 and mutant matrilin-3, thereby inferring a potential chondro-protective role in resolving non-native disulphide bonded aggregates in MED. An established biochemical approach was employed to test the hypothesis that all MATN3-MED disease causing mutations have a generic cellular response to the β-sheet V194D mutation, consisting of intracellular retention, protein aggregation and ER stress induction. Several missense mutations were selected for analyses which encompassed a spectrum of disease severity and included examples of both β-sheet and alpha helical mutations. It was possible to define a reliable and reproducible assay for categorising MATN3 missense mutations into pathological or benign based on these basic parameters. This study was extended further to determine whether there were common pathological mechanisms behind MED and Bethlem myopathy (BM) caused by missense mutations in von Willebrand Factor A domain (vWF-A) containing proteins (matrilin-3 and type VI collagen respectively). We chose to compare and contrast the effects of an archetypal MATN3-MED causing mutation (R121W) with the equivalent COL6A2-BM causing mutation (R876H). These mutations compromised protein folding and maturation, resulting in the familiar disease profile of intracellular retention, protein aggregation and an ER stress response in an artificial overexpression system. However, the mutant C2 domain was efficiently targeted for degradation whilst mutant matrilin-3 vWF-A domain appeared to be resistant to these molecular processes.Molecular genetics was employed to study the role of Creld2 in vivo. Creld2-/- null mice (both global and conditional) were generated to directly examine the role of Creld2 in endochondral bone growth. Global knock-out mice were viable with no overt phenotype at birth. However, female Creld2-/- null mice showed a significant reduction in body weight and tibia bone length at 3 weeks of age. A cartilage specific knock-out was generated to determine whether these skeletal abnormalities were attributed to a systemic or a direct effect on cartilage development. [Creld2Flox/Flox Col2Cre (+)] demonstrated a severe chondrodysplasia with significantly reduced body weight and long bone growth compared to control littermates. Morphological and histochemical analysis of mutant growth plates revealed gross disorganisation of the chondrocyte columns with extensive regions of hypocellularity. These pathological features were confirmed to be the result of reduced chondrocyte proliferation and increased/spatially dysregulated apoptosis throughout all zones of differentiation. Taken together, these data provide evidence that Creld2 possesses isomerase activity and exhibits distinct substrate specificity. Furthermore, Creld2 has a fundamental role in post-natal cartilage development and chondrocyte differentiation in the growth plate.

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13031号 / 論医博第2113号 / 新制||医||1016(附属図書館) / 32989 / (主査)教授 妻木 範行, 教授 安達 泰治, 教授 開 祐司 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Mesosaurier, kleine Reptilien aus dem Unteren Perm, gelten als die frühesten aquatischen Reptilien. Trotz ihrer kurzen Existenz und begrenzten Verbreitung bieten sie wichtige Einblicke in die frühe Amnioten-Evolution. Diese Arbeit fasst vier Artikel zusammen, die Aspekte der Anatomie, Ontogenese und Ökologie von Mesosauridae beleuchten. Kapitel 1 behandelt die Knochenhistologie und Pachyosterosklerose in Mesosaurierknochen, was auf eine vollständig aquatische Lebensweise hinweist. Wir identifizieren auch eine große intraspezifische Variation, die möglicherweise durch unregelmäßige Probenahmeorte beeinflusst wird. Kapitel 2 untersucht die morpho¬logische Variation bei Mesosauriern und deren Umwelt-verteilung basierend auf ihrer Größe. Ontogenetische Veränderungen stehen im Zusammenhang mit dem Wechsel des Ablagerungsmilieus und deuten auf Veränderungen in Ernährung und Lebensraum mit dem Wachstum hin. In Kapitel 3 wird die kaudale Autotomie bei Mesosauriern überprüft und das Vorhandensein kaudaler Bruchebenen bestätigt. Wir schlagen eine stärker von den Extremitäten angetriebene Fortbewegung vor. Unsere Ergebnisse legen nahe, dass kaudale Autotomie ursprünglich in einer breiten Gruppe von Reptilien vorhanden war, anstatt konvergent in verschiedenen Linien entstanden zu sein. Kapitel 4 beschreibt auf Grundlage von Mesosaurier-Exemplaren vier grundlegende axiale Entwicklungs-modelle bei Amnioten und rekonstruiert ihren ursprünglichen Zustand in der Klade. Diese Muster bleiben im Laufe der Zeit relativ stabil, obwohl regionale Einflüsse möglich sind. Diese Erkenntnisse beleuchten wichtige Aspekte der Mesosaurier-Paläontologie und unterstreichen ihre Bedeutung für die Erforschung der Evolution früher Amnioten. / The enigmatic mesosaurs were small, reptiles that lived during the Lower Permian period and were the earliest known reptiles to return to living in water. Despite their short existence and restricted geographical distribution, mesosaurs can provide important evidence about the early evolution of amniotes and the colonization of aquatic environments. This thesis regroups four articles published in peer-reviewed journals that investigate aspects of the anatomy, ontogeny, and ecology of Mesosauridae. In Chapter 1, my co-authors and I study bone histology and pachyosterosclerosis in the long bones, vertebrae, and ribs of mesosaurs. Thin sections show a high degree of osteosclerosis in their bones, supporting a fully aquatic lifestyle. We also recover a large intraspecific variation in Mesosauridae, albeit possibly due to irregular sampling locations. In Chapter 2 we examine morphological variation in mesosaurs and the environmental distribution of individuals as a function of size. We highlight ontogenetic changes in mesosaurs associated with a transition across depositional environments, which suggest that mesosaurs underwent diet and life environment change with growth. In Chapter 3, we review the information on caudal autotomy in mesosaurs. We confirm the presence of caudal fracture planes in the clade and propose a more limb-driven propulsion than previously considered. Our results also suggest that caudal autotomy was ancestrally present in a large radiation of reptiles, rather than a feature evolved convergently in multiple lineages. In Chapter 4, based on data in mesosaur specimens, we describe four axial developmental patterns in amniotes and reconstruct their ancestral condition in the clade. We demonstrate that these patterns are relatively stable throughout time, albeit possibly affected by regionalization. These new elements reveal crucial aspects of mesosaur paleontology and substantiate their significance for studying the evolution of early amniotes.

O objetivo deste trabalho foi estudar o efeito da radioterapia na profilaxia da ossificação heterotópica (OH) em pacientes com lesão medular traumática. Foram estudados 19 pacientes (15 homens e quatro mulheres), média de idade de 30,4 ± 10,8 anos (19 a 58 anos), com lesão medular traumática. A causa mais freqüente da lesão medular foi acidente de trânsito (42,1%), seguida por queda (26,3%), ferimento por projétil de arma de fogo (21%), mergulho (5,3%) e queda de objeto sobre as costas (5,3%). Dez pacientes eram tetraplégicos (52,6%) e nove (47,4%) eram paraplégicos. Apresentavam lesão medular completa (Frankel A) 14 pacientes (73,7%) e cinco pacientes (25,3%) tinham lesão incompleta (Frankel B). Todos os pacientes incluídos no estudo realizaram cintilografia óssea inicial até um mês após o traumatismo raquimedular e apresentaram diagnóstico negativo para OH. Os pacientes foram divididos em dois grupos: nove pacientes receberam radioterapia em dose única de 8 Gy nos quadris (Grupo Estudo) e 10 pacientes compuseram o Grupo Controle. Após seis meses de seguimento clínico e radiológico, um paciente do Grupo Estudo (11%) e cinco pacientes do Grupo Controle (50%) apresentaram OH. A distribuição da freqüência do desenvolvimento da OH nos dois grupos não mostrou diferença estatística significante, apesar da menor incidência de OH no grupo submetido à radioterapia (Grupo Estudo). Concluiu-se que, com o número de pacientes estudados, não foi possível comprovar a eficácia da radioterapia na prevenção da ossificação heterotópica, ainda que haja uma forte tendência para a correlação estatística / The goal of this study was to evaluate the effect of radiotherapy on the prophylaxis of heterotopic ossification (HO) after spinal cord injury (SCI). Nineteen SCI patients were studied (15 men and four women). The mean age was 30.4 ± 10.8 years (range 19 to 58 years). The most frequent causes of lesion were traffic accident (42.1%), fall (26.3%), shot gun (21%), diving (5.3%) and objects falling on the vertebral column (5.3%). Ten patients were tetraplegics (52.6%) and nine were paraplegics. Fourteen patients (73.7%) had complete lesion (Frankel A) and five had incomplete lesion (Frankel B). All patients realized initial scintigraphy until one month after SCI and showed negative results for HO. The patients were randomized in two groups: nine patients received single dose irradiation with 8 Gy on the hips (Study Group) and 10 patients were the Control Group. After six months of clinical and radiological follow up, one patient of the Study Group (11%) and five patients of Control Group (50%) showed HO. The frequency distribution of the development of HO in both groups showed no significant statistical difference, although there was lower incidence of HO in the radiotherapy group. We concluded that, with the number of patients studied, it was no possible to prove the efficacy of radiotherapy to prevent HO, although had a strong tendency for the statistical correlation