title: Bone graft substitutes in active or suspected infection. Contra-indicated or not?
abstract: Treatment of infection in clinical orthopaedic and trauma care is a time consuming and costly endeavour. More than once, it will lead to extraction of implant material and additional surgical interventions. Currently, debridement, implantation of PMMA beads impregnated with antibiotics most often with implant exchange are the gold standard for deep infection treatment. Recently bone graft substitute materials such as calcium phosphate, collagen fleeces and bioglasses have appeared for specific use in infection treatment. Although these materials show great potential, their supporting level of evidence is still limited. This review paper provides an overview of current understanding and therapies for infection treatment and provides concepts for the use of new developed biomaterials in infection treatment. Furthermore, the benefits and risks of using biomaterials in infection treatment are discussed and the level of evidence of a number of new materials is presented.
authors.affiliation: Department of Orthopaedic Surgery, Research School Caphri, Maastricht University Medical Centre, Maastricht, The Netherlands. j.geurts@mumc.nl
authors.forename: Jan
authors.initials: J
authors.lastname: Geurts
authors.forename: J J
authors.initials: JJ
authors.lastname: Chris Arts
authors.forename: G H I M
authors.initials: GH
authors.lastname: Walenkamp
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018441:Biofilms; D001843:Bone Cements / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000009:adverse effects / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use; D003094:Collagen / Q000627:therapeutic use; D003646:Debridement; D016503:Drug Delivery Systems; D006801:Humans; D019904:Polymethyl Methacrylate / Q000008:administration & dosage / Q000627:therapeutic use*; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000209:etiology; D012086:Reoperation
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D018786:Bone Substitutes; D002130:Calcium Phosphates; D003094:Collagen; D019904:Polymethyl Methacrylate