title: Antibiotic-impregnated cement spacer as definitive management for osteomyelitis.
abstract: BACKGROUND
  Osteomyelitis is a challenge for orthopaedic surgeons. There is a lack of scientific evidence to guide treatment. The purpose of this study was to report the clinical outcome of unplanned retention of antibiotic-impregnated cement spacer (ACS) in the management of osteomyelitis.
  
  
  METHODS
  Eight patients (7 with tibial infections and 1 with a calcaneal infection) with osteomyelitis received radical debridement and insertion of an ACS into the bone defect as the definitive management. The mean follow-up period was 2 years (6 months to 4 years). All of these patients had a cement spacer in place.
  
  
  RESULTS
  No patient exhibited radiographic evidence of excessive bone loss. The patients reported no or occasional mild pain and exhibited complete weight-bearing abilities, with the exception of one patient who required a crutch because of a spinal cord injury. Signs of recurrence of the osteomyelitis were not noted in any of the patients, and no fractures occurred at last follow-up.
  
  
  CONCLUSIONS
  Our study suggests that a proportion of patients with unplanned retention of ACS appear to function well without necessarily requiring further surgical intervention.
authors.affiliation: Department of Orthopaedics, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China. qiu_xusheng@163.com.
authors.forename: Xu-Sheng
authors.initials: XS
authors.lastname: Qiu
authors.affiliation: Department of Orthopaedics, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China. thindy1980@163.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Department of Orthopaedics, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China. shihongfei37@163.com.
authors.forename: Hong-fei
authors.initials: HF
authors.lastname: Shi
authors.affiliation: Department of Orthopaedics, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China. tonyzuyanjiu@163.com.
authors.forename: Yan-cheng
authors.initials: YC
authors.lastname: Zhu
authors.affiliation: Department of Orthopaedics, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China. wwwguoxia@qq.com.
authors.forename: Xia
authors.initials: X
authors.lastname: Guo
authors.affiliation: Department of Orthopaedics, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China. mhj198829@163.com.
authors.forename: Hai-jun
authors.initials: HJ
authors.lastname: Mao
authors.affiliation: Department of Orthopaedics, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China. 15366066188@163.com.
authors.forename: Guang-yue
authors.initials: GY
authors.lastname: Xu
authors.affiliation: Department of Orthopaedics, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China. chenyixin93@126.com.
authors.forename: Yi-xin
authors.initials: YX
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001843:Bone Cements / Q000627:therapeutic use*; D002111:Calcaneus / Q000187:drug effects / Q000601:surgery; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000601:surgery; D013977:Tibia / Q000187:drug effects / Q000382:microbiology* / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements