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Clinical outcomes and complications of S53P4 bioactive glass in chronic osteomyelitis and septic non-unions: a retrospective single-center study

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Introduction

Dead space management following debridement surgery in chronic osteomyelitis or septic non-unions is one of the most crucial and discussed steps for the success of the surgical treatment of these conditions. In this retrospective clinical study, we described the efficacy and safety profile of surgical debridement and local application of S53P4 bioactive glass (S53P4 BAG) in the treatment of bone infections.

Methods

A consecutive single-center series of 38 patients with chronic osteomyelitis (24) and septic non-unions (14), treated with bioactive glass S53P4 as dead space management following surgical debridement between May 2015 and November 2020, were identified and evaluated retrospectively.

Results

Infection eradication was reached in 22 out of 24 patients (91.7%) with chronic osteomyelitis.

Eleven out of 14 patients (78.6%) with septic non-union achieved both fracture healing and infection healing in 9.1 ± 4.9 months. Three patients (7.9%) developed prolonged serous discharge with wound dehiscence but healed within 2 months with no further surgical intervention. Average patient follow-up time was 19.8 months ± 7.6 months.

Conclusion

S53P4 bioactive glass is an effective and safe therapeutic option in the treatment of chronic osteomyelitis and septic non-unions because of its unique antibacterial properties, but also for its ability to generate a growth response in the remaining healthy bone at the bone-glass interface.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Author information

Author notes

  1. Simone Daniel Gatti and Diego Gaddi contributed equally to this research.

Authors and Affiliations

  1. School of Medicine and Surgery, University of Milano, Bicocca, Monza, Italy

    Simone Daniel Gatti, Marco Turati, Fabio Pessina, Mattia Carminati, Giovanni Zatti, Laura De Rosa & Marco Bigoni

  2. Department of Orthopedic Surgery, Policlinico San Pietro, Ponte San Pietro, Italy

    Diego Gaddi & Marco Bigoni

  3. Orthopedic Department, IRCCS San Gerardo dei Tintori, Via Pergolesi, 33, 20900, Monza, Italy

    Marco Turati, Giulio Leone, Giovanni Zatti & Laura De Rosa

  4. Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca - Hospital Couple Enfant, Monza (Italy), Grenoble, France

    Marco Turati & Marco Bigoni

  5. Department of Paediatric Orthopedic Surgery, Hospital Couple Enfants, Grenoble Alpes University, Grenoble, France

    Marco Turati

  6. Department Orthopaedic Biomechanics, Faculty Biomedical Engineering, Eindhoven University of Technology TU/e, Eindhoven, Netherlands

    Jacobus J. Arts

  7. Department Orthopaedic Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands

    Jacobus J. Arts

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  1. Simone Daniel Gatti
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Contributions

All authors equally contributed in the making of this manuscript.

Corresponding author

Correspondence to Marco Turati.

Ethics declarations

Ethics approval

This study was approved by the Ethics Committee of the University of Milano Bicocca.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

Informed consent was obtained from all individual participants included in the study.

Competing interests

Dr J. J. Arts is a member of the clinical advisory board of Bonalive.

Conflict of interest

The authors declare that they have no conflicts of interest concerning this article, with the exception of Jacobus J. J. Arts who is a member of the clinical advisory board of Bonalive Ltd., Turku, Finland. No financial support has been received by the authors for the preparation of this paper.

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This manuscript has not been published previously and is not under consideration for publication elsewhere. The publication of this article has been approved by all authors and by the responsible authorities where the work was carried out. We declare that, if accepted, this manuscript will not be published elsewhere, including electronically in the same form, in English or in any other language, without the written consent of the copyright-holder.

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Highlights

•A limited number of studies explore the clinical use of S53P4 BAG in the orthopedic setting.

•S53P4 BAG was used both in long bone chronic osteomyelitis and in long bone septic non-unions.

•S53P4 BAG can be mixed with biologic autologous osteogenic supplements for large bone gaps.

•S53P4 BAG has a high safety profile.

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Gatti, S.D., Gaddi, D., Turati, M. et al. Clinical outcomes and complications of S53P4 bioactive glass in chronic osteomyelitis and septic non-unions: a retrospective single-center study. Eur J Clin Microbiol Infect Dis 43, 489–499 (2024). https://doi.org/10.1007/s10096-023-04737-z

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