Severe Heterotopic ossification bilateral hip

40 yr old HO post head injury  and femoral head fracture with grade 4 Brooker HO and a non healing posterior wound post previous  attempt at excision.

 

 Pre operative  Radiation on the day of surgery was done to reduce  recurrence stimulan with antibiotic and an acetabular  cement spacer  inserted and wound closed with VAC to eliminate dead space was done. Standard 6 weeks 2 bactericidal antibiotic and antibiotic free 6 week window was done before  a constrained liner and THR was done again with VAC. The second time intra op cultures are awaited. the rt hip has a jog of painless movement at present.