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 , AB ). Twenty-one patients experienced reinfection (BAG , 29 %; AB , 19 %). Seventy-eight patients achieved full weight bearing (BAG , 92 %; AB , 97 %). Sixty-four patients had complete bone healing at the end of the follow-up period (BAG , 77 %; AB , 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 (.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.

Highlights

  • The goals of osteomyelitis therapy are successful control of infection and reconstruction of the bone

  • The autologous bone graft and the bioactive glass group were comparable with respect to sex, localization and kind of fracture, and the number of previous operations and flaps (Table 1)

  • Staphylococcus aureus and coagulase-negative Staphylococci were the most common pathogens involved in both groups

Read more

Summary

Introduction

The goals of osteomyelitis therapy are successful control of infection and reconstruction of the bone. 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. Conclusions: Bioactive glass appears to be a suitable bone substitute for successful control of infection and defect filling and for bone healing in cases of infected non-union. Bioactive glass was neither superior nor inferior to autologous bone graft with regard to the primary and secondary endpoints. Successful infection control is essential in the treatment of chronic osteomyelitis and infected non-union. The PMMA beads must be removed in a further operation (Ferguson et al, 2017; Geurts et al, 2011), and, after releasing the antibiotics, they can themselves act as a Published by Copernicus Publications on behalf of EBJIS and MSIS

Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call