Recently in traumatology various methods of impregnation biodegradable implants and allografts with antibiotics are widely used. Among them the soaking, shaking and ionophores are common used. We aimed to choose the optimal method of impregnation with the antibiotic of the head of the femur, taken from patients after arthroplasty. We studied 6 femoral heads after hip replacement. Head №1 the iohexol (Omnipaque) was injected through circular ligament and through the neck of the femur. Head №2 through the circular ligament, head №3 through the neck of the femur, head №4 through the circular ligament and through the neck of the femur, head №5 through 4 pre-drilled channels a brilliant green solution was injected. The head №6 was soaked in a brilliant green solution. Head №1 assessed by radiology. All the heads, treated with brilliant green, were cut in half to assess the degree of impregnation. On the X-ray image of head №1 the contrast agent has spread enough. In osteotomy, the impregnation with brilliant green head №2, №3, №4, №5 was seen in 3–4 mm around the needle passage place. Head №6 the bone was not impregnated. Despite the fact that the radiograph showed a sufficient spread of contrast agent, on the sections of the head, treated with brilliant green, showed the spread of liquid 3–4 mm around the needle passage place. This indicates that the impregnation of large bone is not effective.
The different biodegradable local antibiotic delivery systems are widely used in recent years. The aim of this study was to evaluate the bactericidal activity antibiotic loaded PerOssal pellet in vitro and its effectiveness in the treatment of Staphylococcus aureus induced chronic osteomyelitis. MALDI-TOF have been applied to microbiological diagnosis in patient with osteomyelitis. In most cases, Staphylococcus aureus was isolated. In vitro Ceftriaxone-Loaded PerOssal pellet were placed in middle agar plate containing a stock strain of Staphylococcus aureus. Plates were incubated at 37ºC for 24 hours. The zones of bacterial inhibition were recorded after 24, 48 and 72 hours of incubation. In vivo evaluation was performed by prospectively studying of 21 patients with a clinically and bacteriologically diagnosed Staphylococcus aureus induced osteomyelitis. Mean age was 38±4,2(26 to 53)). After radical surgical debridement and ultrasound cavitation, the bone cavity was full filled with Perosal pellets loaded with different antibiotics depending from the antibiotic sensitivity test. Endpoints were the absence of clinical manifestation of infection or disease recurrence, no need for further surgery.Background
Material and methods
