Bioactive glass for long bone infection: a systematic review

Area of Science:

• Orthopaedic Surgery
• Biomaterials Science
• Infectious Diseases

Background:

• Long bone infections present significant challenges for orthopaedic surgeons.
• Current treatments involve debridement, bone void filling with substitutes, and antibiotics.
• The optimal bone substitute for these infections remains under investigation.

Purpose of the Study:

• To systematically review the clinical outcomes of using bioactive glass as a bone substitute in treating long bone infections.

Main Methods:

• A systematic literature search was conducted on Medline via Pubmed up to August 2015.
• Studies reporting the use of bioactive glass for human long bone infections were included.
• Data from eligible studies were analyzed.

Main Results:

• Three studies involving 41 patients (mean age 46.5 years) met the inclusion criteria.
• All patients received BAG-S53P4 bioactive glass granules to fill bone cavities after osteomyelitis debridement.
• After a mean follow-up of 21 months, three cases of osteomyelitis recurred, often linked to underestimated volumes or inadequate skin coverage. No direct complications from the bioactive glass were reported.

Conclusions:

• Bioactive glass (BAG-S53P4) appears to be a viable bone substitute for long bone infections.
• Its properties include antibacterial activity, osteoconductivity, and vascular stimulation.
• Careful consideration of graft volume and wound closure is crucial for optimal outcomes.