DALLAS – March 2026: – Researchers at UT Southwestern Medical Center are part of a team that developed a simple blood test that can detect heterotopic ossification (HO), the abnormal formation of bone in soft tissues after injury or surgery, weeks before it can be identified by traditional imaging. Their findings, published in Nature Communications1, could potentially lead to earlier treatment for patients at risk.
HO develops in muscles, tendons, or other soft tissues in a significant proportion of trauma and joint replacement patients when the body’s natural repair response overcorrects or is misdirected. Symptoms can include pain, swelling, joint stiffness, reduced range of motion, and the formation of misplaced bone.
“Heterotopic ossification is a fairly common complication of trauma and some types of surgery,” said co-corresponding author Benjamin Levi, M.D., Professor of Surgery and Chief of the Division of Burn, Trauma, Acute and Critical Care Surgery at UT Southwestern.
“The body is working overtime to repair itself, and if those efforts are short-circuited at the cellular level, it leads to bone growth where there shouldn’t be any. Rather than waiting six to eight weeks for bone to appear on a CT scan or X-ray as we do today, our findings suggest that clinicians could identify molecular changes that lead to HO within hours to days after injury or surgery,” said Dr. Levi, who also serves as Director of UTSW’s Center for Organogenesis, Regeneration, and Trauma.
UTSW researchers and colleagues at Massachusetts General Hospital in Boston focused on rare cells in the blood – known as circulating mesenchymal progenitor cells (cMPCs) – that are involved in abnormal bone formation. Using blood samples from trauma-induced mouse models and UT Southwestern patients who had undergone hip replacement surgery, the researchers isolated these cells using a microfluidic device called an iChip. They then analyzed the cells’ gene expression to build a risk prediction model that was 90% successful in identifying HO formation.
The test also could be used to monitor treatment response by detecting reductions in HO risk after clinical intervention – usually physical therapy, radiation, pain medication, or surgery.
“Currently, up to 80% of patients who don’t have HO receive unnecessary preventive treatment such as radiation or nonsteroidal anti-inflammatory drugs after trauma or surgery because of the delay in identifying HO via traditional imaging.”Johanna Nunez, M.D., UTSW Burn Surgery
“A blood-based ‘liquid biopsy’ tool like this could allow early identification, reducing complications, costs, overtreatment, and associated risks while improving precision, monitoring, and safety,” said Johanna Nunez, M.D., UTSW Burn Surgery and Critical Care fellow and the study’s first author.
The study is an extension of previous research the Levi Lab has conducted on the pathology and treatment of heterotopic ossification. The new diagnostic test, which has a patent pending, will undergo additional research to further evaluate its effectiveness.
“While this study focused on HO after trauma, burns, or joint replacements, it’s possible that the blood test platform could be used with other disorders involving abnormal tissue repair, such as osteoarthritis and fibrosis-related conditions,” said Dr. Levi, who holds secondary appointments in the Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, Children’s Medical Center Research Institute at UT Southwestern (CRI), and Plastic Surgery.
Reference:
1) https://www.nature.com/articles/s41467-026-68857-8
(Newswise/HG)