Abstract
Osteomyelitis is a devastating disease caused by the infection of bone tissue and is associated with significant morbidity and mortality. It is treated with antibiotic therapy and surgical debridement. A high dose of systemic antibiotics is often required due to poor bone penetration and this is often associated with unacceptable side-effects. To overcome this, local, implantable antibiotic carriers such as polymethyl methacrylate have been developed. However, this is a non-biodegradable material that requires a second surgery to be removed. Attention has therefore shifted to new antibiotic-eluting scaffolds which can be created with a range of unique properties. The purpose of this review is to assess the level of evidence that exists for these novel local treatments. Although this field is still developing, these strategies seem promising and provide hope for the future treatment of chronic osteomyelitis.
Highlights
Osteomyelitis is a devastating disease caused by the infection of bone tissue and is associated with significant morbidity and mortality
The incidence of bloodborne osteomyelitis has dramatically reduced following the introduction of systemic antibiotics [7]
Given that bone scaffolds are implanted in areas of dead space, they should have mechanical properties consistent with that anatomical site to prevent the risk of fracture [27]
Summary
Osteomyelitis is an inflammatory bone disease caused by infection. It is most commonly associated with skin commensals such as the bacterium Staphylococcus aureus [1]. The symptoms of osteomyelitis can either present themselves acutely, or chronically The distinction between these subsets is pivotal to treatment. Once there is dead bone, bone abscesses or biofilm formation, complete surgical debridement is required [10] This is usually the case in chronic osteomyelitis [10]. Sci. 2020, 10, x FOR PEER REVIEW classification and clinical context (Figure 1) [11] This is a staging system for osteomyelitis based on the based on boundaries the anatomical boundaries infection and theofphysiological status of the host. Should always be taken for microbiology and histology assessment [10]
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