Long-term outcomes of lower limb post-traumatic osteomyelitis

Area of Science:

• Orthopedics
• Infectious Diseases
• Rehabilitation Medicine

Background:

• Post-traumatic osteomyelitis (PTOM) of the tibia and femur can lead to significant morbidity.
• While recurrence and amputation rates are documented, patient-reported functional outcomes are less understood.
• This knowledge gap hinders effective patient counseling regarding treatment expectations.

Purpose of the Study:

• To investigate patient-reported outcome measures (PROMs) in individuals with PTOM.
• To establish a reference for functional outcomes to aid in pre-treatment patient discussions.
• To identify factors associated with improved functional outcomes in PTOM patients.

Main Methods:

• A 7-year retrospective, single-institution study of patients with PTOM of the tibia/femur.
• Collected data on recurrence, amputation, and PROMs including the Lower Extremity Functional Scale (LEFS), EQ-5D-3L, and EQ-VAS.
• Analyzed 72 patients, with PROMs collected from 84% at a median of 112 months post-treatment.

Main Results:

• Seventy-two patients (median age 46) were included; 12 experienced recurrence, 9 underwent amputation.
• Median LEFS was 60, EQ-5D-3L index was 0.760, and EQ-VAS was 80, all lower than general population norms.
• Functional outcomes (LEFS, EQ-5D-3L) were significantly better when the Reamer-Irrigator-Aspirator (RIA) was used and in uncomplicated BACH classifications.

Conclusions:

• Patients with PTOM report significantly lower functional outcomes compared to the general population, even in remission.
• The use of the Reamer-Irrigator-Aspirator (RIA) and management of uncomplicated PTOM are associated with improved functional outcomes.
• These findings provide crucial data for managing patient expectations and guiding treatment strategies in PTOM.