Abstract. Introduction:
The goals of osteomyelitis therapy are successful control of infection and
reconstruction of the bone. The gold standard for filling defects is the
autologous bone graft. Bioactive glass S53P4 is an inorganic bone
substitute. We compared the outcome of using bioactive glass (BAG) versus
autologous bone graft (AB) in patients with infected non-union.
Methods:
Patients with chronic osteomyelitis and infected non-union who received
either bioactive glass or autologous bone grafts between 2013 and 2017 were
analyzed retrospectively. The primary endpoint was successful control of
infection during follow-up. Secondary endpoints were bone healing,
functional outcome, and occurrence of complications.
Results:
Eighty-three patients were analyzed (BAG n=51, AB n=32). Twenty-one
patients experienced reinfection (BAG n=15, 29 %; AB n=6, 19 %).
Seventy-eight patients achieved full weight bearing (BAG n=47, 92 %; AB
n=31, 97 %). Sixty-four patients had complete bone healing at the end of
the follow-up period (BAG n=39, 77 %; AB n=25, 78 %). There were no
significant differences between the groups with respect to the primary or
secondary endpoints. Patients with multidrug-resistant pathogens had a
significantly higher rate of incomplete bone healing (p=0.033) and a 3-fold
higher risk of complications in both groups.
Conclusions:
Bioactive glass appears to be a suitable bone substitute not only for
successful control of infection and defect filling but also for bone healing
in cases of infected non-union. In our study, bioactive glass was neither
superior nor inferior to autologous bone graft with regard to the primary
and secondary endpoints. Further studies with larger numbers of patients are
required.
Role of Primary Autologous Bone Graft at Docking Site in the Treatment of Infected Non-union Tibia Using Rail Fixation System
