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Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_23 | Pages 39 - 39
1 Dec 2016
TREATMENT OF CHRONIC OSTEOMYELITIS OF THE LOWER LIMB WITH A NEW INJECTABLE, VANCOMYCIN-LOADED, CALCIUM SULFATE / HYDROXYAPATITE COMPOSITE
Glombitza M Steinhausen E
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Aim

Treatment principles of chronic osteomyelitis include debridement, clean sampling, excision of dead bone, stabilization, dead space management, soft tissue closure and systemic antibiotic therapy. Dead space management becomes very complicated, if the bone infection is caused by multi-resistant bacteria. The aim of this investigation was to evaluate the effect of a new vancomycin-loaded hydroxyapatite / calcium sulfate composite* in the treatment of chronic osteomyelitis (OM) caused by multi-resistant bacteria.

Method

From June 2015 to November 2015, 7 patients (4 males, 3 females, average age 52.6y) were treated according to the above mentioned principles using the new vancomycin-loaded hydroxyapatite / calcium sulfate composite*. Infections were caused by methicillin-resistant Staphylococcus aureus (MRSA), multi-resistant Staphylococcus epidermidis (MRSE) and polymicrobial, vancomycin-sensitive bacteria.

We used a two-stage protocol with debridement, excision of bone and external stabilization in the first stage, followed by bone defect reconstruction. To fill the residual bone defects, in 3 patients the new vancomycin-loaded hydroxyapatite / calcium sulfate composite* (10mL) was used on its own and in 4 patients combined with 18mL of an unloaded calcium sulfate / hydroxyapatite composite**. Post-operative follow-up was evaluated clinically and by radiographs and CT scans at 6, 14 and 24 weeks.