The use of dissolving local antibiotic delivery systems in orthopedic surgery is improving the way we treat infection. Early analysis of a small cohort suggests that antibiotic-loaded calcium sulfate-coated interlocking intramedullary nails (CS-IMN) are safe and may be as effective as the more established method for infection eradication. Future studies with larger cohorts of patients will be required to confirm these findings.

This study consists of 26 patients with infection of the pubic symphysis. The authors believe that by drawing awareness to this condition patients may be diagnosed and undergo surgery faster; 21 of the patients had pelvic surgery before onset of pubic infection. The diagnostic delay was between 1 and 12 months. All patients underwent surgical debridement and received a minimum of 6 weeks antibiotic treatment; 23 patients had postoperative pain relief and 19 patients were ambulant without aids.

Osteomyelitis is an infection of bone and is often treated with surgical debridement. This results in a bone defect which requires the use of a void filler. This study evaluated the use of a gentamicin-impregnated ceramic void filler (CERAMENT G) and compared it to the same void filler without antibiotic (CERAMENT) and no void filler in a rat model of osteomyelitis. CERAMENT G was found to decrease the rate of persistent infection and grow more new bone than CERAMENT or an empty defect.

This case series highlights our treatment strategy for pubic symphysis osteomyelitis of aggressive local debridement with local antibiotic therapy. Additionally, debridement of the pubic symphysis without subsequent internal fixation did not result in pelvic instability, as determined by pelvic radiographs and ability to fully weight bear postoperatively.

Chronic bone infections often present with major bone and soft tissue loss which can be difficult to manage. In this study, we treated the most complex infections using surgery which reconstructed all of the tissues in one operation. We showed that this was a safe approach with very good outcomes. All of the bones healed and 96.5 % of patients were infection-free at final follow-up. This type of surgery requires close cooperation of a multidisciplinary team with expertise in major infections.