The Fate of Antibiotic Impregnated Cement Space in Treatment for Forefoot Osteomyelitis

Inha Woo; Jeongjin Park; Hyungyu Seok; Tae-gon Kim; Jun Sung Moon; Seung Min Chung; Chul Hyun Park

doi:10.3390/jcm11071976

The Fate of Antibiotic Impregnated Cement Space in Treatment for Forefoot Osteomyelitis

J Clin Med. 2022 Apr 1;11(7):1976. doi: 10.3390/jcm11071976.

Authors

Inha Woo¹, Jeongjin Park¹, Hyungyu Seok¹, Tae-gon Kim², Jun Sung Moon³, Seung Min Chung³, Chul Hyun Park⁴

Affiliations

¹ Department of Orthopedics, Yeungnam University Hospital, Daegu 38541, Korea.
² Department of Plastic Surgery, College of Medicine, Yeungnam University, Daegu 38541, Korea.
³ Department of Internal Medicine, Division of Endocrinology and Metabolism, College of Medicine, Yeungnam University, Daegu 38541, Korea.
⁴ Department of Orthopaedic Surgery, College of Medicine, Yeungnam University, Daegu 38541, Korea.

Abstract

Forefoot osteomyelitis can be an extremely challenging problem in orthopedic surgery. Unlike conventional methods, such as amputations, antibiotic impregnated cement space (ACS) was recently introduced and perceived as a substitute for amputation. The purpose of this study was to compare clinical features between diabetic and non-diabetic groups and to evaluate the efficacy of ACS in the treatment of forefoot osteomyelitis, by identifying the clinical characteristics of ACS. We inserted ACS into the forefoot osteomyelitis patients and regularly checked up on them, then analyzed the clinical features of the patients and failure reasons, if ACS had to be removed. Average survival rate of ACS was 60% (21 out of 35 cases) and main failure reason was recurrence of infection. There was no significant clinical difference between diabetic and non-diabetic groups. We concluded that ACS could be a possible way of avoiding amputation if infection is under control. ACS seems to be an innovative method with promising results for foot osteomyelitis, but widely accepted indications need to be agreed upon.

Keywords: antibiotics impregnated cement spacer; diabetic foot; forefoot osteomyelitis; single center study.

Grants and funding

This research was supported by a grant of the MD-Phd/Medical Scientist Training Program through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea.