Abstract
Text: Chronic osteomyelitis is a serious condition. The infection can be difficult to eradicate and destroy significant bone. Usual therapy includes debridement, systemic antibiotics and local antibiotic delivery with polymethylmethacrylate (PMMA). PMMA needs to be removed and does not aid in bone repair.
Purpose: To review the use of calcium sulfate (OSTE-OSET® loaded with Vancomycin 3.2% or Tobramycin 3.8%) as an antibiotic delivery and bone repair implant.
Methods: Six consecutive patients were reviewed. Clinical records, radiographs, bone repair, sedimentation rate, functional outcome (Enneking MSTS system) were evaluated. All patients were treated with a surgical debridement, degradable implants and six weeks of systemic antibiotics.
Results: Six patients (3M/3F), mean age 50 years. Site; tibia 3, femur 3. Organism: Staph Aureus 5, mixed 1. Defect size; 40 cubic centimeters (12–60). Pre op sed rate; 54 (22–105). Local antibiotic; tobramycin 5, tobra+vancomycin 1. Follow-up; 22 months (12–31). Follow up sed rate; 8, Follow-up defect size; 2.5 cubic centimeters. Bone repair, 91%. Follow-up functional score; 27.5/30. No fractures, infection relapses or additional surgery to date.
Discussion: Local antibiotic delivery with calcium sulfate (OSTEOSET®) proved to be effective for bone repair. This implant does not need to be removed and may be an adjunct to systemic antibiotics for chronic osteomyelitis.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
