Abstract

IntroductionOsteomyelitis refers to an inflammatory process affecting the bone and bone marrow. Chronic disease occurs following the formation of a necrotic, devascularised sequestrum. Regardless of the approach, treatment is complex and resource-intensive, often requiring multiple surgical interventions and extended antibiotic therapy. This study aims to review the treatment of chronic osteomyelitis of the femur by a single surgeon over seven years (January 2013 to January 2020).Materials and methodsWe retrospectively reviewed a consecutive series of 14 patients. Data collected includes age, sex, medical history, treatment, pathogen, C-reactive protein levels, outcome, and follow-up period. The EuroQOL five-dimensional questionnaire (EQ-5D-5L) and Visual Analogue Scale (EQ-VAS) were used to assess health outcomes. Data concerning total treatment costs and reimbursement received was also collected.ResultsAlthough 10/14 (71.4%) patients were considered in remission at final follow-up, only six (42.9%) achieved remission and showed no recurrence after initial treatment. The mean total treatment cost was £39,249.50, with a mean deficit of - £19,080.10 when considering reimbursement. Patients showed a significantly lower mean EQ-5D score (0.360) compared to the national population mean of 0.856 (P = .0018) as well as a lower mean EQ-VAS (61.7) compared to the population norm of 82.8 (P = .013). ConclusionThe extensive nature of the infection, high rates of co-morbidity, and the growth of more than a single pathogen may explain the lower success rate observed. In these patients, recurrence may be highly likely and thus regular follow-up is vital in order to ensure effective management.

Highlights

  • Osteomyelitis refers to an inflammatory process affecting the bone and bone marrow

  • 10/14 (71.4%) patients were considered in remission at final follow-up, only six (42.9%) achieved remission and showed no recurrence after initial treatment

  • Using the hospital electronic patient record system, we retrospectively reviewed the personal logbook of the senior author (MK) for patients treated for chronic osteomyelitis of the femur between January 2013 and January 2020

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Summary

Objectives

This study aims to review the treatment of chronic osteomyelitis of the femur by a single surgeon over seven years (January 2013 to January 2020). We aim to assess treatment outcomes in terms of infection eradication and complications such as infection recurrence or requirement for further treatment

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