title: Bioactive glass for long bone infection: a systematic review.
abstract: BACKGROUND
  Long bone infection remains a challenging situation for the orthopaedic surgeon. For most, treatment comprises a thorough debridement of all the infected bone, the filling of the resultant cavity with a bone substitute, and general antibiotics for a certain time. However, the type of bone substitute to insert in the cavity is still debated.
  
  
  OBJECTIVE
  In this study, we aimed to systematically review the results of studies using bioactive glass for long bone infection in the clinical setting.
  
  
  METHODS
  We searched systematically Medline via Pubmed for studies published until August 2015 that report the results of bioactive glass for long bone infection in humans.
  
  
  RESULTS
  Three studies, including a total of 41 patients, met the inclusion criteria. Mean age was 46.5 (16-84). Twenty-nine were male and twelve were female. Period of inclusion went from 2007 to 2013. All the patients had a clinically and radiologically diagnosed osteomyelitis. They all underwent a state of the art surgical procedure to address osteomyelitis. All the patients were implanted with BAG-S53P4 granules (BonAlive Biomaterials Ltd, Turku, Finland) to fill in the resultant cavity. Mean volume inserted was 16.8 milliliters (2-60). After a mean follow-up of 21 months (10-38), three cases of osteomyelitis recurred. In two cases, a new procedure was performed. No complication directly related to the bioactive glass was reported.
  
  
  CONCLUSIONS
  Despite a limited use for long bone infection in humans, bioactive glass seems to be an interesting option as bone substitute after thorough bone debridement and skin coverage. It associates antibacterial activities, osteoconductive properties and vascular stimulation.
  
  
  CONCLUSIONS
  From this review, bioactive glass seems to be a useful bone substitute for long bone infection in humans. Few recurrences occurred after its use. In these cases, the volume of bone glass to insert was frequently underestimated and/or the skin coverage not adequate.
authors.affiliation: Department of Orthopaedic, Trauma and Reconstructive Surgery, Antoine Béclère Hospital, AP-HP, Paris Sud University, 157 rue de la Porte de Trivaux, 92140 Clamart, France; Laboratory of Bioengineering and Biomechanics for Bone Articulation (B2OA - UMR CNRS 7052), Paris-Diderot University, 10 avenue de Verdun, 75010 Paris, France. Electronic address: aureganjc@yahoo.fr.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Aurégan
authors.affiliation: Department of Orthopaedic, Trauma and Reconstructive Surgery, Antoine Béclère Hospital, AP-HP, Paris Sud University, 157 rue de la Porte de Trivaux, 92140 Clamart, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Bégué
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D018786:Bone Substitutes / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods*; D005260:Female; D005898:Glass; D006801:Humans; D010019:Osteomyelitis / Q000503:physiopathology / Q000601:surgery*; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents; D018786:Bone Substitutes; C403922:bioactive glass S53P4
keywords: bioactive glass; bone infection; osteomyelitis