Antibiotic-impregnated cement spacer as definitive management for osteomyelitis

BMC Musculoskelet Disord. 2015 Sep 14:16:254. doi: 10.1186/s12891-015-0704-1.

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.

Conclusion: Our study suggests that a proportion of patients with unplanned retention of ACS appear to function well without necessarily requiring further surgical intervention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Bone Cements / therapeutic use*
  • Calcaneus / drug effects
  • Calcaneus / surgery
  • Disease Management
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Osteomyelitis / diagnosis*
  • Osteomyelitis / drug therapy*
  • Osteomyelitis / surgery
  • Tibia / drug effects
  • Tibia / microbiology*
  • Tibia / surgery

Substances

  • Anti-Bacterial Agents
  • Bone Cements