Qiu Xu-Sheng, Zheng Xin, Shi Hong-fei, Zhu Yan-cheng, Guo Xia, Mao Hai-jun, Xu Guang-yue, Chen Yi-xin
Department of Orthopaedics, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China.
BMC Musculoskelet Disord. 2015 Sep 14;16:254. doi: 10.1186/s12891-015-0704-1.
Osteomyelitis is a challenge for orthopaedic surgeons. There is a lack of scientific evidence to guide treatment. The purpose of this study was to report the clinical outcome of unplanned retention of antibiotic-impregnated cement spacer (ACS) in the management of osteomyelitis.
Eight patients (7 with tibial infections and 1 with a calcaneal infection) with osteomyelitis received radical debridement and insertion of an ACS into the bone defect as the definitive management. The mean follow-up period was 2 years (6 months to 4 years). All of these patients had a cement spacer in place.
No patient exhibited radiographic evidence of excessive bone loss. The patients reported no or occasional mild pain and exhibited complete weight-bearing abilities, with the exception of one patient who required a crutch because of a spinal cord injury. Signs of recurrence of the osteomyelitis were not noted in any of the patients, and no fractures occurred at last follow-up.
Our study suggests that a proportion of patients with unplanned retention of ACS appear to function well without necessarily requiring further surgical intervention.
骨髓炎对骨科医生来说是一项挑战。目前缺乏指导治疗的科学证据。本研究的目的是报告在骨髓炎治疗中意外保留抗生素骨水泥间隔物（ACS）的临床结果。
8例骨髓炎患者（7例胫骨感染，1例跟骨感染）接受了根治性清创，并在骨缺损处植入ACS作为最终治疗方法。平均随访期为2年（6个月至4年）。所有这些患者体内均有骨水泥间隔物。
没有患者出现影像学证据显示骨量过度丢失。患者报告无疼痛或偶尔有轻微疼痛，除1例因脊髓损伤需要使用拐杖外，其余患者均具备完全负重能力。所有患者均未出现骨髓炎复发迹象，最后一次随访时也未发生骨折。
我们的研究表明，一部分意外保留ACS的患者似乎功能良好，不一定需要进一步的手术干预。
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