Mid-term clinical results of chronic cavitary long bone osteomyelitis treatment using S53P4 bioactive glass: a multi-center study

<p><strong>Introduction</strong>: Chronic osteomyelitis is a challenging condition in the orthopedic practice and traditionally treated using local and systemic antibiotics in a two-stage surgical procedure. With the introduction of the antimicrobial biomaterial S53P4 bioactive gla...

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Autores principales:	T. A. G. Van Vugt, J. Heidotting, J. J. Arts, J. J. W. Ploegmakers, P. C. Jutte, J. A. P. Geurts
Formato:	article
Lenguaje:	EN
Publicado:	Copernicus Publications 2021
Materias:	Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/202d83da87e043a89c1a4dbe5a9635fe
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spelling	oai:doaj.org-article:202d83da87e043a89c1a4dbe5a9635fe2021-11-12T13:58:32ZMid-term clinical results of chronic cavitary long bone osteomyelitis treatment using S53P4 bioactive glass: a multi-center study10.5194/jbji-6-413-20212206-3552https://doaj.org/article/202d83da87e043a89c1a4dbe5a9635fe2021-11-01T00:00:00Zhttps://jbji.copernicus.org/articles/6/413/2021/jbji-6-413-2021.pdfhttps://doaj.org/toc/2206-3552<p><strong>Introduction</strong>: Chronic osteomyelitis is a challenging condition in the orthopedic practice and traditionally treated using local and systemic antibiotics in a two-stage surgical procedure. With the introduction of the antimicrobial biomaterial S53P4 bioactive glass (Bonalive<sup>®</sup>), chronic osteomyelitis can be treated in a one-stage procedure. This study evaluated the mid-term clinical results of patients treated with S53P4 bioactive glass for long bone chronic osteomyelitis. <strong>Methods</strong>: In this prospective multi-center study, patients from two different university medical centers in the Netherlands were included. One-stage treatment consisted of debridement surgery, implantation of S53P4 bioactive glass, and treatment with culture-based systemic antibiotics. If required, wound closure by a plastic surgeon was performed. The primary outcome was the eradication of infection, and a secondary statistical analysis was performed on probable risk factors for treatment failure. <strong>Results</strong>: In total, 78 patients with chronic cavitary long bone osteomyelitis were included. Follow-up was at least 12 months (mean 46; standard deviation, SD, 20), and 69 patients were treated in a one-stage procedure. Overall infection eradication was 85 %, and 1-year infection-free survival was 89 %. Primary closure versus local/muscular flap coverage is the only risk factor for treatment failure. <strong>Conclusion</strong>: With 85 % eradication of infection, S53P4 bioactive glass is an effective biomaterial in the treatment of chronic osteomyelitis in a one-stage procedure. A major risk factor for treatment failure is the necessity for local/free muscle flap coverage. These results confirm earlier published data, and together with the fundamentally different antimicrobial pathways without antibiotic resistance, S53P4 bioactive glass is a recommendable biomaterial for chronic osteomyelitis treatment and might be beneficial over other biomaterials.</p>T. A. G. Van VugtJ. HeidottingJ. J. ArtsJ. J. ArtsJ. J. W. PloegmakersP. C. JutteJ. A. P. GeurtsCopernicus PublicationsarticleOrthopedic surgeryRD701-811ENJournal of Bone and Joint Infection, Vol 6, Pp 413-421 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811
spellingShingle	Orthopedic surgery RD701-811 T. A. G. Van Vugt J. Heidotting J. J. Arts J. J. Arts J. J. W. Ploegmakers P. C. Jutte J. A. P. Geurts Mid-term clinical results of chronic cavitary long bone osteomyelitis treatment using S53P4 bioactive glass: a multi-center study
description	<p><strong>Introduction</strong>: Chronic osteomyelitis is a challenging condition in the orthopedic practice and traditionally treated using local and systemic antibiotics in a two-stage surgical procedure. With the introduction of the antimicrobial biomaterial S53P4 bioactive glass (Bonalive<sup>®</sup>), chronic osteomyelitis can be treated in a one-stage procedure. This study evaluated the mid-term clinical results of patients treated with S53P4 bioactive glass for long bone chronic osteomyelitis. <strong>Methods</strong>: In this prospective multi-center study, patients from two different university medical centers in the Netherlands were included. One-stage treatment consisted of debridement surgery, implantation of S53P4 bioactive glass, and treatment with culture-based systemic antibiotics. If required, wound closure by a plastic surgeon was performed. The primary outcome was the eradication of infection, and a secondary statistical analysis was performed on probable risk factors for treatment failure. <strong>Results</strong>: In total, 78 patients with chronic cavitary long bone osteomyelitis were included. Follow-up was at least 12 months (mean 46; standard deviation, SD, 20), and 69 patients were treated in a one-stage procedure. Overall infection eradication was 85 %, and 1-year infection-free survival was 89 %. Primary closure versus local/muscular flap coverage is the only risk factor for treatment failure. <strong>Conclusion</strong>: With 85 % eradication of infection, S53P4 bioactive glass is an effective biomaterial in the treatment of chronic osteomyelitis in a one-stage procedure. A major risk factor for treatment failure is the necessity for local/free muscle flap coverage. These results confirm earlier published data, and together with the fundamentally different antimicrobial pathways without antibiotic resistance, S53P4 bioactive glass is a recommendable biomaterial for chronic osteomyelitis treatment and might be beneficial over other biomaterials.</p>
format	article
author	T. A. G. Van Vugt J. Heidotting J. J. Arts J. J. Arts J. J. W. Ploegmakers P. C. Jutte J. A. P. Geurts
author_facet	T. A. G. Van Vugt J. Heidotting J. J. Arts J. J. Arts J. J. W. Ploegmakers P. C. Jutte J. A. P. Geurts
author_sort	T. A. G. Van Vugt
title	Mid-term clinical results of chronic cavitary long bone osteomyelitis treatment using S53P4 bioactive glass: a multi-center study
title_short	Mid-term clinical results of chronic cavitary long bone osteomyelitis treatment using S53P4 bioactive glass: a multi-center study
title_full	Mid-term clinical results of chronic cavitary long bone osteomyelitis treatment using S53P4 bioactive glass: a multi-center study
title_fullStr	Mid-term clinical results of chronic cavitary long bone osteomyelitis treatment using S53P4 bioactive glass: a multi-center study
title_full_unstemmed	Mid-term clinical results of chronic cavitary long bone osteomyelitis treatment using S53P4 bioactive glass: a multi-center study
title_sort	mid-term clinical results of chronic cavitary long bone osteomyelitis treatment using s53p4 bioactive glass: a multi-center study
publisher	Copernicus Publications
publishDate	2021
url	https://doaj.org/article/202d83da87e043a89c1a4dbe5a9635fe
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Mid-term clinical results of chronic cavitary long bone osteomyelitis treatment using S53P4 bioactive glass: a multi-center study

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