Treatment of chronic osteomyelitis by using antibiotic: containing bone cement beads

Ha, Snag Ho; Pyo, Young Bai; Park, Jung Kwang

Abstract

Since Klemm introduced the concept of antibiotic-containing bone cement for the treatment of chronic osteomyelitis, a number of studies have demonstrated the positive results of this therapy. It has been proved that antibiotic-containing bone cement continuously releases high levels of atibiotics locally into the infected and avascular wound environment. Antibiotic-containing bone cement provides several distinct advantages over irrigation-suction drainage. The major objective of this study is to analyze the results of therapy using antibiotic-containing bone cement beads for chronic osteomyelitis. The authors analyzed 21 cases of chronic osteomyelitis in patients who had been treated by saucerization and antibiotic-containing bone cement beads at Chosun University Hospital, between February 1990 and January 1993. Each patient's case was followed for at least thirteen months after operation. The results are as follows: 1. The causes of osteomyelitis were postoperative complications(10 patients), open fracture(8 patients), and hematogenous osteomyelitis(3 patients). 2. Staphylococcus aureus was the most common organism causing osteomyelitis, followed by Pseudomonas. 3. The femur was the most common location of lesion(11 patients) followed by the tibia(7 patients), the humerus(2 patients) and the ulna (1 patients). 4. Pus drainage was stopped in 13 cases with one insertion of the beads, in 2 cases with two insertions and in 2 cases with three insertions. 5. Therapy using antibiotic-containing bone cement beads can be regraded as an effective method of increasing local antibacterial activity by releasing the antibiotic into surrounding tissue over a continuous period in the treatment of chronic osteomyelitis. Antibiotic-containing bone cement beads are useful in the treatment of chronic osteomyelitis.