JBJI Journal of Bone and Joint Infection JBJI J. Bone Joint Infect. 2206-3552 Ivyspring Göttingen, Germany 10.7150/jbji.38373 Current Insights in the Application of Bone Grafts for Local Antibiotic Delivery in Bone Reconstruction Surgery Peeters Arne 1 Putzeys Guy 2 Thorrez Lieven 3 Faculty of Medicine, KU Leuven, Leuven, Belgium Orthopedic Centre, AZ Groeninge, Kortrijk, Belgium Department of Development and Regeneration, KU Leuven, Kortrijk, Belgium 15 10 2019 4 5 245 253 Copyright: © 2019 Arne Peeters et al. 2019 This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/ This article is available from https://jbji.copernicus.org/articles/4/245/2019/jbji-4-245-2019.html The full text article is available as a PDF file from https://jbji.copernicus.org/articles/4/245/2019/jbji-4-245-2019.pdf

<p class="p p-first" id="__p2"><strong>Introduction:</strong> Bone implant related infection is still one of the biggest challenges in bone and joint surgery. Antibiotic impregnated bone grafts seem to be promising in both treatment and prevention of these infections. However, great variance in methodology predominates this field of research. This paper gives an overview of the published literature.</p><p id="__p3"><strong>Methods:</strong> The PRISMA-flowchart was used as protocol for article selection. Medline was searched and articles were selected in accordance with predetermined exclusion criteria.</p><p id="__p4"><strong>Results:</strong> Forty-eight articles were included in the synthesis. Topics including bone graft type, manipulations of the graft, elution profile, bacterial inhibition, osteotoxicity, incorporation, special impregnation methods, clinical use and storage were investigated.</p><p id="__p5">Therapeutically, high initial levels seem appropriate for biofilm eradication. A single stage procedure in the treatment of bone implant related infection seems feasible. Prophylactically, the literature indicates a reduction of postoperative infections when using antibiotic impregnated bone grafts.</p><p class="p p-last" id="__p6"><strong>Conclusion:</strong> Bone grafts are a suitable carrier for local antibiotic application both therapeutically and prophylactically.</p>

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