Treatment of chronic osteomyelitis with one-stage allograft.
OBJECTIVE
To avoid disadvantages of two-stage cancellus bone autograft, we investigated the feasibility of one-stage allograft for reconstructing the bone defect resulting from debridement of chronic osteomyelitis in limbs.


METHODS
Between Feb. 1999 and Apr. 2004, 35 cases of chronic osteomyelitis (8 cases of nonunion) underwent one-stage allograft after debridement in our hospital.


RESULTS
Thirty-five cases were followed up for an average period of 28 months (range, 13 to 55 months), in which 32 cases (91.43%) were found no infection, and 3 cases (8.57%) were confirmed recurrence of infection. Four out of 8 cases of bone nonunion healed in 9.5 months on average (range, 3 to 12 months), and another case also acquired union after redebridement and autograft of ilium due to infection recurrence 35 days after surgery. Renonunion occurred in 3 cases, 2 out of whom healed after secondary operation with autograft. One case of renonunion and 2 cases of infection recurrence refused further treatment.


CONCLUSIONS
A high rate of infection arrest can be attained when one-stage allograft is used to reconstruct the bone defect of chronic osteomyelitis after debridement in limbs. Therefore, chronic osteomyelitis should not be regarded as a contraindication to one-stage allogeneic bone grafting. Renonuion, however, achieves a relatively high rate, especially in cases of segmental bone defect.
Lu
Wei-ju
WJ
Department of Orthopedics, General Hospital, Nanjing Unit of PLA, Nanjing 210002, China. tianyazhichi@vip.sina.com
Li
Bin
B
Bao
Ni-rong
NR
Qian
Hong-bo
HB
Zeng
Xiao-feng
XF
Xu
Bin
B
Chen
Yong
Y
Zhao
Jian-ning
JN
D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000601:surgery*; D014184:Transplantation, Homologous