Efficacy of Antibiotic Impregnated Allogenic Bone Graft as Local Antibiotic Delivery System in Controlled Osteoarticular Infection

摘要

[Introduction] Osteomyelitis is dreaded infection necessitating prolonged and sustained antibiotic therapy which carries the disadvantages of systemic adverse effects and high cost of therapy. Current study aims to assess safety and efficacy of use antibiotic loaded allogenic cancellous bone as a carrier of antibiotics in controlled osteoarticular infection.[Materials and Methods] Study involved case series of twelve patients with localized and controlled osteoarticular infection. Hydrophilic antibiotics were selected according to common organism responsible for the osteoarticular infection and culture and sensitivity. Allogenic cancellous antibiotics impregnated bone graft augmented with autologous bone graft or Bone marrow aspirate was used along with appropriate surgical procedure.[Results] Patients were evaluated for infection eradication and osteointegration. Over all6 cases were treated successfully thus obviating any subsequent procedure. Infection was eradicated in10 cases. Osteointegration was achieved in all the cases in which autologous bone graft was used as adjuvant and in two out of four cases in which bone marrow aspirate was also used). Two cases were considered failure which required secondary procedures and change of fixation.[Conclusion)しancelious bone allograft as antibiotic carrier clinically provided safe, prolong and effective local antibiotic for treating osteoarticular Infection. It may be superior to surgical debridement and systemic antibiotic alone for infection eradication and may offer better osteointegration when used along with adjuvants like autologous bone graft or Bone marrow.[Level of Evidence] levelIV, Study can serve clinical basis of using the allogenic bone graft as carrier of antibiotics for safe and cost benencial treatment of osteoarticular infection avoiding side effects of systemic antibiotics and simultaneously aiding bone healing by osteointregation.