The treatment of chronic osteomyelitis often includes surgical debridement and filling the resultant void with antibiotic-loaded polymethylmethacrylate cement, bone grafts or bone substitutes. Recently, the use of bioactive glass to treat bone defects in infections has been reported in a limited series of patients. However, no direct comparison between this biomaterial and antibiotic-loaded bone substitute has been performed. In this retrospective study, we compared the safety and efficacy of surgical debridement and local application of the bioactive glass S53P4 in a series of 27 patients affected by chronic osteomyelitis of the long bones (Group A) with two other series, treated respectively with an antibiotic-loaded hydroxyapatite and calcium sulphate compound (Group B; n = 27) or a mixture of tricalcium phosphate and an antibiotic-loaded demineralised bone matrix (Group C; n = 22). Systemic antibiotics were also used in all groups. After comparable periods of follow-up, the control of infection was similar in the three groups. In particular, 25 out of 27 (92.6%) patients of Group A, 24 out of 27 (88.9%) in Group B and 19 out of 22 (86.3%) in Group C showed no infection recurrence at means of 21.8 (12 to 36), 22.1 (12 to 36) and 21.5 (12 to 36) months follow-up, respectively, while Group A showed a reduced wound complication rate. Our results show that patients treated with a bioactive glass without local antibiotics achieved similar eradication of infection and less drainage than those treated with two different antibiotic-loaded calcium-based bone substitutes.
|Titolo:||A comparative study of the use of bioactive glass S53P4 and antibiotic-loaded calcium-based bone substitutes in the treatment of chronic osteomyelitis : a retrospective comparative study|
|Parole Chiave:||Bioglass; Bone; Bone substitute; Infection; Osteomyelitis; Adult; Aged; Aged, 80 and over; Analysis of Variance; Anti-Bacterial Agents; Bone Substitutes; Calcium Sulfate; Chronic Disease; Cohort Studies; Combined Modality Therapy; Debridement; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Osteomyelitis; Retrospective Studies; Risk Assessment; Severity of Illness Index; Statistics, Nonparametric; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Wound Healing; Young Adult; Glass; Orthopedics and Sports Medicine; Surgery|
|Settore Scientifico Disciplinare:||Settore MED/07 - Microbiologia e Microbiologia Clinica|
|Data di pubblicazione:||giu-2014|
|Digital Object Identifier (DOI):||10.1302/0301-620X.96B6.33014|
|Appare nelle tipologie:||01 - Articolo su periodico|