scholarly journals Mid-term clinical results of chronic cavitary long bone osteomyelitis treatment using S53P4 bioactive glass: a multi-center study

2021 ◽  
Vol 6 (9) ◽  
pp. 413-421
Author(s):  
Tom A. G. Van Vugt ◽  
Jeffrey Heidotting ◽  
Jacobus J. Arts ◽  
Joris J. W. Ploegmakers ◽  
Paul C. Jutte ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Bioactive Glass ◽  
Chronic Osteomyelitis ◽  
Clinical Results ◽  
Long Bone ◽  
One Stage ◽  
Eradication Of Infection ◽  
Multi Center Study ◽  
Long Bone Osteomyelitis ◽  
Systemic Antibiotics

Abstract. Introduction: Chronic osteomyelitis is a challenging condition in the orthopedic practice and traditionally treated using local and systemic antibiotics in a two-stage surgical procedure. With the introduction of the antimicrobial biomaterial S53P4 bioactive glass (Bonalive®), chronic osteomyelitis can be treated in a one-stage procedure. This study evaluated the mid-term clinical results of patients treated with S53P4 bioactive glass for long bone chronic osteomyelitis. Methods: In this prospective multi-center study, patients from two different university medical centers in the Netherlands were included. One-stage treatment consisted of debridement surgery, implantation of S53P4 bioactive glass, and treatment with culture-based systemic antibiotics. If required, wound closure by a plastic surgeon was performed. The primary outcome was the eradication of infection, and a secondary statistical analysis was performed on probable risk factors for treatment failure. Results: In total, 78 patients with chronic cavitary long bone osteomyelitis were included. Follow-up was at least 12 months (mean 46; standard deviation, SD, 20), and 69 patients were treated in a one-stage procedure. Overall infection eradication was 85 %, and 1-year infection-free survival was 89 %. Primary closure versus local/muscular flap coverage is the only risk factor for treatment failure. Conclusion: With 85 % eradication of infection, S53P4 bioactive glass is an effective biomaterial in the treatment of chronic osteomyelitis in a one-stage procedure. A major risk factor for treatment failure is the necessity for local/free muscle flap coverage. These results confirm earlier published data, and together with the fundamentally different antimicrobial pathways without antibiotic resistance, S53P4 bioactive glass is a recommendable biomaterial for chronic osteomyelitis treatment and might be beneficial over other biomaterials.

scholarly journals Cost-Effectiveness Study of One-Stage Treatment of Chronic Osteomyelitis with Bioactive Glass S53P4

Materials ◽  
2019 ◽  
Vol 12 (19) ◽  
pp. 3209 ◽  
Author(s):  
Jan Geurts ◽  
Tom van Vugt ◽  
Eline Thijssen ◽  
Jacobus J. Arts
Keyword(s):  
Cost Effectiveness ◽  
Clinical Outcome ◽  
Bioactive Glass ◽  
Chronic Osteomyelitis ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Base Case ◽  
Control Group ◽  
Two Stage ◽  
One Stage

This study was set up to evaluate the costs of a one-stage treatment of chronic osteomyelitis using bioactive glass S53P4 versus a two-stage treatment using gentamicin-loaded PMMA beads. Furthermore, a cost-effectiveness analysis was performed from a hospital’s perspective together with the evaluation of clinical outcome. A treatment group (n = 25) receiving one-stage surgery with bioactive glass was retrospectively compared with a two-stage control group (n = 25). An assessment was made of all costs included from first outpatient visit until one year after treatment. Bootstrap simulation and sensitivity analyses were performed. The primary endpoint was cost-effectiveness with clinical outcome as the secondary endpoint. The base case analyses shows dominance of the one-stage treatment with bioactive glass S53P4 due to lower costs and a better clinical outcome. Sensitivity analyses confirm these findings. This study is the first in its kind to show one-stage treatment of chronic osteomyelitis with bioactive glass S53P4 to be cost-effective.

scholarly journals The Antibiotic Use in Osteomyelitis Infection: A Systematic Review

2021 ◽  
Vol 9 (F) ◽  
pp. 720-723
Author(s):  
Panji Sananta ◽  
Thomas Erwin Christian Junus Huwae ◽  
Daniel Ronadi ◽  
Lasa Dhakka Siahaan
Keyword(s):  
Systematic Review ◽  
Antibiotic Treatment ◽  
English Language ◽  
Chronic Osteomyelitis ◽  
Antibiotic Use ◽  
Long Bone ◽  
Publication Date ◽  
Acute Osteomyelitis ◽  
Antibiotics Use ◽  
Long Bone Osteomyelitis

Introduction: Osteomyelitis is a serious infection of the bone. One of the therapies for osteomyelitis is antibiotic treatment. Antibiotic treatment has evolved substantially, but bone infections are still a challenge. Antimicrobial therapy is also difficult, caused by antibiotic-resistant organisms.  Therefore, a systematic review is needed to assess antibiotic use in osteomyelitis infection. Method: Articles were searched using Pubmed with keywords “antibiotics”, “osteomyelitis”, and its combination. The authors used five years publication date and English language to select the appropriate journal. Result: The author identified 13 relevant articles with antibiotics use in osteomyelitis. All of the cases were about chronic osteomyelitis and osteomyelitis in diabetic foot ulcers. Osteomyelitis in other sites of long bones needs longer duration treatment than long bone osteomyelitis. In acute osteomyelitis in children, antibiotic treatment can switch from IV to oral antibiotics. Furthermore, chronic osteomyelitis needs longer treatment to resolve than acute osteomyelitis. Conclusion: Antibiotics still mainstay treatment with surgery for osteomyelitis treatment. With acute, children, and long bone only need shorter treatment than chronic, adult, and non-long bone osteomyelitis.

Bioactive glass S53P4 to fill-up large cavitary bone defect after acute and chronic osteomyelitis treated with antibiotic-loaded cement beads: a prospective case series with a minimum 2-year follow-up

Injury ◽  
2021 ◽  
Author(s):  
Kodi Edson Kojima ◽  
Fernando Brandão de Andrade e Silva ◽  
Marcos de Camargo Leonhardt ◽  
Vladimir Cordeiro de Carvalho ◽  
Priscila Rosalba Domingos de Oliveira ◽  
...  
Keyword(s):  
Bioactive Glass ◽  
Bone Defect ◽  
Chronic Osteomyelitis ◽  
Case Series ◽  
Prospective Case Series

scholarly journals Treatment of Infected Tibial Non-Unions with Ilizarov Technique: A Case Series

2020 ◽  
Vol 9 (5) ◽  
pp. 1352 ◽  
Author(s):  
Gianluca Testa ◽  
Andrea Vescio ◽  
Domenico Costantino Aloj ◽  
Danilo Costa ◽  
Giacomo Papotto ◽  
...  
Keyword(s):  
Bioactive Glass ◽  
Antibacterial Properties ◽  
Case Series ◽  
Long Bone ◽  
Ilizarov Technique ◽  
Fixation Technique ◽  
Bone Resection ◽  
Bone Segment ◽  
The Mean

Background: The Ilizarov external fixation technique has been widely used for the treatment of long-bone infected non-unions. After surgical infected bone resection, to allow filling of the remaining bone gap, biomaterials with antibacterial properties could be used. The aim of this study was to report outcomes of infected tibial non-unions treated using the Ilizarov technique and antibacterial bioactive glass. Methods: Between April 2009 and December 2014, 26 patients with infected tibial non-unions were treated with the Ilizarov technique and possible use of the bioactive glass, S53P4. The Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria, a clinical and radiographic evaluating tool, was used for assessing the sample. Results: The average age at the start of treatment was 51 years. The mean follow-up time was 113 weeks. According to the ASAMI Functional Scoring System, 10 excellent (38.5%) cases and 12 good (46.1%) values were recorded. According to the ASAMI Radiological System, they were excellent in 16 (61.5%) cases and good in nine (34.6%). Conclusions: Treatment of infected tibial non-unions using the Ilizarov technique was effective in bone segment regeneration. To fill the remaining bone gap, additional bioactive glass S53P4 could be used, allowing a decrease in re-interventions and minimizing complications.

scholarly journals Preliminary Experience Using Bioactive Glass Wedges for Cotton Osteotomy

2018 ◽  
Vol 3 (4) ◽  
pp. 247301141879686
Author(s):  
Tood Borenstein ◽  
Tyler Gonzalez ◽  
Janet Krevolin ◽  
Bryan Den Hartog ◽  
David Thordarson
Keyword(s):  
Bioactive Glass ◽  
Case Series ◽  
Clinical Results ◽  
Delayed Union ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Opening Wedge ◽  
Radiographic Outcomes ◽  
Initial Correction

Background: Medial cuneiform dorsal opening wedge (Cotton) osteotomy is often used for treating forefoot varus in patients undergoing surgery for stage II posterior tibialis tendon dysfunction. The goal of this study was to examine the radiographic outcomes of Cotton osteotomy with bioactive glass wedge to assess for both maintenance of correction and clinical results and complications. We hypothesized that bioactive glass wedges would maintain correction of the osteotomy with low complication rates. Methods: Between December 2015 and June 2016, the charts of 17 patients (10 female and 7 male) who underwent Cotton osteotomy using bioactive glass wedges were retrospectively reviewed. Patient age averaged 56.8 years (range, 16-84). The average follow-up was 6.5 months. Radiographs were reviewed to assess for initial correction and maintenance of correction of medial column sag as well as for union. Charts were reviewed for complications. Results: The medial column sag correction averaged 15.6% on the final postoperative lateral radiograph. Meary angle averaged 19 degrees (3.14-42.8 degrees) preoperatively and 5.5 degrees (0.4-20.7 degrees) at final follow-up. All patients achieved clinical and radiographic union. One patient developed neuropathic midfoot pain and was managed with sympathetic blocks. One patient had a delayed union that healed at 6 months without surgical intervention. No patients required the use of custom orthotics or subsequent surgical procedures. Conclusion: Cotton osteotomy with bioactive glass wedges produced consistent correction of the medial column with low risk. Level of Evidence: Level IV, case series.

Chronic long bone osteomyelitis

2011 ◽  
Author(s):  
Peter Calder
Keyword(s):  
Soft Tissues ◽  
Chronic Osteomyelitis ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Autologous Bone Graft ◽  
Bone Transport ◽  
Soft Tissue Defect ◽  
Long Bone ◽  
Space Management ◽  
Secondary Intention

Pathological features of chronic osteomyelitis♦ Necrotic bone♦ Compromised soft tissues with reduction in vascularity♦ Ineffective host response♦ Sequestrum formation♦ New bone formation from viable periosteum and endosteum♦ Formation of involucrum:Treatment principles in chronic osteomyelitis♦ Surgical debridement – remove all devitalized necrotic tissue♦ Dead space management:• Soft tissue defect – avoid healing by secondary intention. Consider local and free flaps• Bone defects – small structural with autologous bone graft, consider Papineau ‘open bone grafting’ where free tissue transfer is not an option, distraction osteogenesis with bifocal and bone transport for large defects including fibula transfer♦ Bone stability – movement needs to be eliminated♦ Antibiotic therapy – based on culture and sensitivity, local administration with PMMA beads or collagen sponge, Lautenbach procedure in resistant cases.

Fibular Nail Fixation: Topical Review

2019 ◽  
Vol 40 (11) ◽  
pp. 1331-1337 ◽  
Author(s):  
Henrik C. Bäcker ◽  
J. Turner Vosseller
Keyword(s):  
Bone Fractures ◽  
Clinical Results ◽  
Long Bone ◽  
Implant Design ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Fracture Stabilization ◽  
Fibular Fracture ◽  
Level Ii ◽  
Intramedullary Implants

Background: Intramedullary implants have been used historically in long bone fractures with success. In recent years, a variety of intramedullary implants for the treatment of fibular fractures have been investigated. These various implants have not been assessed together in a cohesive manner. In this review, we assess implants used for intramedullary fixation of fibular fractures with respect to implant design and clinical results. Methods: A comprehensive systematic literature review for intramedullary implants in fibular fractures was performed. All publications that assessed intramedullary fibular implants were reviewed. In total, 11 different intramedullary nails were found. Clinical results obtained from these studies were reviewed. Results: The intramedullary implants used for fibular fracture fixation generally fell into one of 3 categories: an unlocked longitudinal strut, an implant roughly equivalent to a large screw, or a more traditionally locked intramedullary nail. Reported clinical results were generally good, although inconsistent outcome reporting greatly limited comparison between studies. Complication rates varied with the implants but were generally low. Conclusion: Intramedullary implants for fibular fracture stabilization have changed over the years to improve stability. Although clinical results are limited, data suggest that these implants are safe and can potentially approximate more traditional implants. Level of Evidence: Level II, systematic review.

Sign in / Sign up

Export Citation Format

Share Document