Journal of Bone and Joint Infection
Journal of Bone and Joint Infection
JBJI
Articles | Volume 6, issue 6
Articles | Volume 6, issue 6
https://doi.org/10.5194/jbji-6-199-2021
© Author(s) 2021. This work is distributed under
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-6-199-2021
© Author(s) 2021. This work is distributed under
the Creative Commons Attribution 4.0 License.
Articles | Volume 6, issue 6
Letter
 | 
27 May 2021
Letter |  | 27 May 2021

Comment on “Bioactive glass S53P4 vs. autologous bone graft for filling defects in patients with chronic osteomyelitis and infected non-unions – a single center experience” by Steinhausen et al. (2021)

Martin McNally

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Cited articles

Bidossi, A., Bottagisio, M., Logoluso, N., and de Vecchi, E.: In vitro evaluation of gentamicin or vancomycin containing bone graft substitute in the prevention of orthopedic implant-related infections, Int. J. Mol. Sci., 21, 9250, https://doi.org/10.3390/ijms2139250, 2020. 
Boot, W., Vogely, H., Nikkels, P., Pouran, B., van Rijen, M., and Ekkelenkamp, M.: Prophylaxis of implant-related infections by local release of vancomycin from a hydrogel in rabbits, Eur. Cells Mater., 39, 108–120, 2020. 
Drampalos, E., Mohammad, H. R., Kosmidis, C., Balal, M., Wong, J., and Pillai, A.: Single stage treatment of diabetic calcaneal osteomyelitis with an absorbable gentamicin-loaded calcium sulphate/hydroxyapatite biocomposite: The Silo technique, Foot, 34, 40–44, 2018. 
Dudareva, M., Kümin, M., Vach, W., Kaier, K., Ferguson, J., McNally, M., and Scarborough, M.: Short or Long Antibiotic Regimes in Orthopaedics (SOLARIO): A randomised controlled open-label non-inferiority trial of duration of systemic antibiotics in adults with orthopaedic infection treated operatively with local antibiotic therapy, Trials, 20, 693, https://doi.org/10.1186/s13063-019-3832-3, 2019. 
Ferguson, J. Y., Dudareva, M., Riley, N. D., Stubbs, D., Atkins, B. L., and McNally, M. A.: The use of a biodegradable antibiotic-loaded calcium sulphate carrier containing tobramycin for the treatment of chronic osteomyelitis, Bone Joint J., 96, 829–836, 2014. 
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This paper provides further evidence that treatment of osteomyelitis by serial debridement without the use of local antimicrobials has high recurrence rates (20 %–30 %). The addition of bioglass did not improve this compared to using bone graft alone. Additional systemic antibiotic was required in many cases, increasing the risk of antimicrobial resistance. Recent series of single-stage surgery with local antibiotic delivery have reported better outcomes.
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