Outcome and Predictors of Treatment Failure in Chronic Osteomyelitis Using Bioactive Glass Granules and Putty...

Area of Science:

• Orthopedics
• Biomaterials Science
• Infectious Diseases

Background:

• Chronic cavitary osteomyelitis presents a significant treatment challenge.
• Adjuvant therapies are crucial for improving outcomes in complex bone infections.
• Bioactive glass (BAG) S53P4 is explored for its bone-regenerative and antimicrobial properties.

Purpose of the Study:

• To evaluate the efficacy of bioactive glass S53P4 in treating chronic cavitary osteomyelitis.
• To identify independent risk factors for recurrence after treatment.
• To compare different formulations of BAG S53P4.

Main Methods:

• Retrospective, multicentre observational study.
• Inclusion of patients with chronic cavitary osteomyelitis treated with BAG S53P4 (granule and/or putty).
• Assessment of clinical outcomes and risk factors at 6- and 12-month follow-ups.

Main Results:

• High infection eradication rates: 85.9% at 6 months and 87.2% at 12 months.
• Granule formulation of BAG S53P4 showed a higher risk of recurrence (PR=3.04) compared to putty or combined formulations.
• Neoplasia (PR=5.26), smoking (PR=4.0), and nonfermenting GNB infection (PR=3.87) were identified as risk factors for recurrence.

Conclusions:

• Bioactive glass S53P4 is a viable option for bone-void filling in chronic cavitary osteomyelitis.
• The putty formulation or combined use of BAG S53P4 demonstrated superior results.
• Identifying and managing risk factors like smoking and specific infections is key to preventing recurrence.