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Related Experiment Videos

Chronic Osteomyelitis - Pathophysiology and Treatment.

Markus Rupp1,2, Nike Walter2, Christoph Biehl1

  • 1Universitätsklinikum Gießen, Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, HE, Deutschland, Gießen.

Zeitschrift Fur Orthopadie Und Unfallchirurgie
|June 23, 2026
PubMed
Summary

Chronic osteomyelitis, often caused by biofilms, presents a persistent challenge in orthopaedic surgery. This review details stage-appropriate surgical strategies and interdisciplinary approaches for effective infection control and improved patient outcomes.

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Area of Science:

  • Orthopaedic Surgery
  • Infectious Disease
  • Bacteriology

Background:

  • Chronic osteomyelitis is a complex orthopaedic infection characterized by bacterial biofilm formation.
  • Biofilms reduce antibiotic susceptibility, leading to pathogen persistence and treatment challenges.

Purpose of the Study:

  • To review the pathophysiology of osteomyelitis.
  • To delineate stage-appropriate surgical strategies based on the Cierny-Mader classification.
  • To discuss recent advancements and interdisciplinary treatment concepts.

Main Methods:

  • Literature review focusing on osteomyelitis pathophysiology, classification systems, and treatment modalities.
  • Analysis of surgical strategies including debridement, dead-space management, and reconstruction.
  • Discussion of biofilm mechanisms and evidence-based treatment protocols.

Main Results:

  • Bacterial biofilms are central to chronic osteomyelitis, reducing antibiotic efficacy.
  • The Cierny-Mader classification guides anatomical and physiological staging for treatment.
  • Stage-appropriate interventions include radical debridement, local antibiotic delivery, and reconstruction.

Conclusions:

  • Effective management of chronic osteomyelitis requires understanding biofilm dynamics.
  • Classification-guided, evidence-based treatment protocols are crucial for definitive infection control.
  • Interdisciplinary collaboration and advanced surgical techniques improve functional outcomes.