Abstract | BACKGROUND: METHODS: A retrospective study of 31 consecutive patients with chronic osteomyelitis from one medical center was conducted. The treatment involved thorough debridement, antibiotic loaded bone substitutes filling (group A: CS/CP, 21 patients, group B: CS, 10 patients), laboratory and radiographic examination, and culture-specific systemic antibiotic treatment guided by a multidisciplinary team. New bone formation property and resorption kinetics were analyzed through X-ray and CT scan qualitatively and quantitatively. Anti- infection effect was mainly analyzed by postoperative laboratory examination and healing of wound. RESULTS: The average follow-up in each group was 61.3 and 86.7 weeks, respectively. In group A (CS/ CP), no patient had recurrent infection at 17 months after surgery, 1 case had delayed wound healing and healed after dressing change. In group B (CS), 2 patients had recurrent infection at 18 weeks after surgery, and were managed after further surgical treatment, 3 cases had delayed wound healing and healed after dressing change. The infection in the two groups was mainly caused by staphylococcus aureus. The average percentage of new bone formation was 20.5%, 43.7%, 75.2% at 1, 3, and 6 months in group A and 15.4%, 32.2%, 49.7% at 1, 3, and 6 months in group B after operation (P=0.001 at 1 month, P=0.025 at 3 months, P=0.000 at 6 months). The average percentage of resorption was 23.7%, 56.4%, 81.2% at 1, 3, and 6 months in group A and 47.1%, 96.2%, 100% at 1, 3, and 6 months in group B after operation (P=0.000 at 1 month, P=0.000 at 3 months, P=0.000 at 6 months). There was difference in infection recurrence (P=0.034). CONCLUSIONS: Our preliminary results proved that compared with CS, this novel antibiotic-impregnated CS/CP composite acted as superior scaffold for bone formation with a lower rate of infection recurrence, when choosing bone substitutes in the treatment of chronic osteomyelitis.
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Authors | Zihou Zhao, Guoliang Wang, Yong Zhang, Wen Luo, Shiyu Liu, Yunyan Liu, Yong Zhou, Yunfei Zhang |
Journal | Annals of palliative medicine
(Ann Palliat Med)
Vol. 9
Issue 4
Pg. 1821-1833
(Jul 2020)
ISSN: 2224-5839 [Electronic] China |
PMID | 32279517
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Calcium Phosphates
- Calcium Sulfate
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Topics |
- Calcium Phosphates
(therapeutic use)
- Calcium Sulfate
(therapeutic use)
- Chronic Disease
- Debridement
- Humans
- Osteomyelitis
(drug therapy)
- Retrospective Studies
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