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Part of the series Advances in Experimental Medicine and Biology pp 1-12

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Antibacterial Bioactive Glass, S53P4, for Chronic Bone Infections – A Multinational Study

  • Nina LindforsAffiliated withDepartment of Orthopaedic and Plastic Surgery, Helsinki University Central Hospital, Helsinki University Email author 
  • , Jan GeurtsAffiliated withDepartment of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre
  • , Lorenzo DragoAffiliated withLaboratory of Clinical Chemistry and Microbiology, I.R.C.C.S. Galeazzi Orthopaedic Institute
  • , J. J. ArtsAffiliated withDepartment of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical CentreOrthopaedic Biomechanics Group, Department of Biomedical Engineering, Eindhoven University of Technology (TU/e)
  • , Vesa JuutilainenAffiliated withDepartment of Orthopaedic and Plastic Surgery, Helsinki University Central Hospital, Helsinki University
  • , Pekka HyvönenAffiliated withDepartment of Orthopaedic and Traumatology, Oulu University Hospital
  • , Arnold J. SudaAffiliated withDepartment for Septic Surgery, BG Trauma Center Ludwigshafen
  • , Aloj DomenicoAffiliated withI Orthopaedic Clinic, University of Turin, Orthopaedic and Trauma Center - CTO Hospital
  • , Stefano ArtiacoAffiliated withI Orthopaedic Clinic, University of Turin, Orthopaedic and Trauma Center - CTO Hospital
    • , Chingiz AlizadehAffiliated withAzerbaijan Scientific Research Institute of Traumatology and Orthopaedics
    • , Adrian BrychcyAffiliated withDepartment of Bone and Joint Infections, Orthopedic Clinic of Postgraduate Medical Education Centre
    • , Jertzy BialeckiAffiliated withDepartment of Bone and Joint Infections, Orthopedic Clinic of Postgraduate Medical Education Centre
    • , Carlo L. RomanòAffiliated withCenter for Reconstructive Surgery of Osteoarticular Infections (CRIO), I.R.C.C.S. Galeazzi Orthopaedic Institute

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Abstract

Osteomyelitis is an infectious process in bone that occasionally leads to bone destruction. Traditionally, the surgical treatment procedure is performed in combination with systemic and local antibiotics as a two-stage procedure that uses autograft or allograft bone for filling of the cavitary defect. Bioactive glass (BAG-S53P4) is a bone substitute with proven antibacterial and bone bonding properties.

One hundred and sixteen patients who had verified chronic osteomyelitis was treated using BAG-S53P4 as part of the treatment. Most of the patients had previously undergone numerous procedures, sometimes for decades. A register of patient data obtained from 11 centers from Finland, Italy, the Netherlands, Germany, Azerbaijan and Poland was set-up and continuously maintained at Helsinki University Central Hospital.

The location of the osteomyelitis was mainly in the tibia followed by the femur and then the calcaneus. The median age of the patients was 48 years (15–87). The patients were either treated according to a one-stage procedure without local antibiotics (85 %) or by a two-stage procedure using antibiotic beads in the first procedure (15 %). The minimum follow-up was 1 year (12–95 months, median 31).

The cure rate was 104/116, the total success rate 90 % and most of the patients showed a rapid recovery.

The study shows that (BAG-S53P4) can be used in a one-stage procedure in treatment of osteomyelitis with excellent results.

Keywords

Bioactive glass S53P4 Osteomyelitis Antibacterial Bone substitute