One-stage surgery for adult chronic osteomyelitis: concomitant use of antibiotic-loaded calcium sulphate and bone marrow aspirate

International Orthopaedics
Ahmed Abdel Badie, Mohamed S Arafa

Abstract

To report our experience with one-stage treatment of chronic osteomyelitis using a prospective protocol involving the concomitant use of the antibiotic-loaded calcium sulphate pellets with addition of bone marrow aspirate after bony debridement. A total of 30 patients with the mean age of 26.2 years were treated according to a protocol that included (1) surgical debridement of bone and infected tissues, (2) local antibiotic therapy including vancomycin and garamycin loaded on calcium sulphate space filling biodegradable pellets, (3) bone marrow aspirate added to the biocomposite, (4) primary closure with external fixation (when needed) and (5) intravenous antibiotics according to culture and sensitivity results. After a minimum of one year follow-up, infection was eradicated in 23 (76.7%) patients, the average rate of filling of the bony defect was 70.47%, complete filling of defect in 15 patients (50%) and pathological fracture in one patient. The technique proved safety and efficacy in eradicating the infection and bony healing of the defects after debridement. Simple bone marrow aspiration is cheap, reproducible, safe and not exhausting the scanty autograft resources.

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Citations

Nov 9, 2019·International Orthopaedics·Willem OosthuysenNando Ferreira
Aug 30, 2019·Journal of Orthopaedic Trauma·Willem-Jan MetsemakersUNKNOWN Fracture-Related Infection (FRI) consensus group
Apr 2, 2021·Journal of Healthcare Engineering·Bingyuan LinKai Huang
Jan 5, 2021·Journal of Orthopaedic Trauma·Jessica C RiveraJanet D Conway

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