Adult osteomyelitis: debridement versus debridement plus Osteoset T pellets.
This long-term retrospective study investigated the value of debridement versus debridement and Osteoset T antibiotic-loaded calcium sulphate pellets in the treatment of adult chronic osteomyelitis. Sixty-five patients were included in the study. The mean follow-up was 75 months (range: 36 to 334). Forty cases were treated by debridement, and 25 by debridement and Osteoset T. The healing rates were 60% and 80%, respectively; however, the difference was not significant. In a subgroup of 39 patients with medullary osteomyelitis and a normal immune system (IA according to the Cierny-Mader classification of adult osteomyelitis), 22 patients were treated with debridement, 17 with debridement and Osteoset T. The healing rates were 59% and 94%, respectively (p < 0.05). Twenty-eight patients with Staphylococcus aureus osteomyelitis were also studied apart; 13 were treated with debridement and 15 with debridement and Osteoset T. The healing rates were 46% and 80%, respectively. The difference was not significant. The results obtained with debridement were less good than with debridement plus Osteoset T, but the difference was not significant, except in a single subgroup. Osteoset T obviates the need for removal, which is the rule after implantation of gentamycin beads. Bony ingrowth is however limited.
Chang
Wang
W
Musculoskeletal Oncology Department, Rizzoli Orthopaedic Institute, Bologna, Italy.
Colangeli
Marco
M
Colangeli
Simone
S
Di Bella
Claudia
C
Gozzi
Enrico
E
Donati
Davide
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002133:Calcium Sulfate / Q000627:therapeutic use; D003646:Debridement; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000601:surgery; D014031:Tobramycin / Q000008:administration & dosage*
D000900:Anti-Bacterial Agents; D014031:Tobramycin; D002133:Calcium Sulfate