Osteomyelitis treated with gentamicin-PMMA beads: 100 patients followed for 1-12 years.
We treated 100 patients having osteomyelitis with debridement and gentamicin-PMMA beads and followed them for 5 (1-12) years. 66 of the infections were chronic, in 18 cases combined with arthritis and in 3 cases with pseudarthrosis. They underwent 117 "treatment periods", consisting of one or more operations (total 152), in most cases with an interval of 2 weeks. No systemic antibiotics were necessary besides the local antibiotic treatment in 52 of the treatment periods. Healing was achieved in 92 patients, in 78 after a single treatment period which included 1-5 operations, in 14 after two or three treatment periods. Healing was more difficult to achieve when the infection was chronic, especially with a duration of more than 6 years or when caused by elective surgery. Local antibiotic treatment with gentamicin PMMA beads has the advantage that the wound can be closed primarily and that a higher local antibiotic concentration in the tissues can be achieved, often making systemic antibiotic treatment unnecessary.
Walenkamp
G H
GH
Department of Orthopedic Surgery, Academic Hospital Maastricht, The Netherlands.
Kleijn
L L
LL
de Leeuw
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001843:Bone Cements / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003646:Debridement; D018572:Disease-Free Survival; D004343:Drug Implants; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D010019:Osteomyelitis / Q000209:etiology / Q000628:therapy*; D019904:Polymethyl Methacrylate / Q000627:therapeutic use*; D012008:Recurrence; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D001843:Bone Cements; D004343:Drug Implants; D005839:Gentamicins; D019904:Polymethyl Methacrylate