用于长骨感染的生物活性玻璃：一项系统综述。
Bioactive glass for long bone infection: a systematic review.
作者信息
Aurégan Jean-Charles, Bégué Thierry
机构信息
Department of Orthopaedic, Trauma and Reconstructive Surgery, Antoine Béclère Hospital, AP-HP, Paris Sud University, 157 rue de la Porte de Trivaux, 92140 Clamart, France; Laboratory of Bioengineering and Biomechanics for Bone Articulation (B2OA - UMR CNRS 7052), Paris-Diderot University, 10 avenue de Verdun, 75010 Paris, France.
Department of Orthopaedic, Trauma and Reconstructive Surgery, Antoine Béclère Hospital, AP-HP, Paris Sud University, 157 rue de la Porte de Trivaux, 92140 Clamart, France.
出版信息
Injury. 2015 Dec;46 Suppl 8:S3-7. doi: 10.1016/S0020-1383(15)30048-6.
BACKGROUND
Long bone infection remains a challenging situation for the orthopaedic surgeon. For most, treatment comprises a thorough debridement of all the infected bone, the filling of the resultant cavity with a bone substitute, and general antibiotics for a certain time. However, the type of bone substitute to insert in the cavity is still debated.
PURPOSE
In this study, we aimed to systematically review the results of studies using bioactive glass for long bone infection in the clinical setting.
MATERIAL AND METHOD
We searched systematically Medline via Pubmed for studies published until August 2015 that report the results of bioactive glass for long bone infection in humans.
RESULTS
Three studies, including a total of 41 patients, met the inclusion criteria. Mean age was 46.5 (16-84). Twenty-nine were male and twelve were female. Period of inclusion went from 2007 to 2013. All the patients had a clinically and radiologically diagnosed osteomyelitis. They all underwent a state of the art surgical procedure to address osteomyelitis. All the patients were implanted with BAG-S53P4 granules (BonAlive Biomaterials Ltd, Turku, Finland) to fill in the resultant cavity. Mean volume inserted was 16.8 milliliters (2-60). After a mean follow-up of 21 months (10-38), three cases of osteomyelitis recurred. In two cases, a new procedure was performed. No complication directly related to the bioactive glass was reported.
DISCUSSION
Despite a limited use for long bone infection in humans, bioactive glass seems to be an interesting option as bone substitute after thorough bone debridement and skin coverage. It associates antibacterial activities, osteoconductive properties and vascular stimulation.
CONCLUSION
From this review, bioactive glass seems to be a useful bone substitute for long bone infection in humans. Few recurrences occurred after its use. In these cases, the volume of bone glass to insert was frequently underestimated and/or the skin coverage not adequate.
背景
对于骨科医生而言，长骨感染仍然是一个具有挑战性的情况。对于大多数病例，治疗包括对所有感染骨进行彻底清创、用骨替代物填充 resulting 腔隙以及在一定时间内使用全身性抗生素。然而，用于填充腔隙的骨替代物类型仍存在争议。
目的
在本研究中，我们旨在系统评价在临床环境中使用生物活性玻璃治疗长骨感染的研究结果。
材料与方法
我们通过 Pubmed 系统检索 Medline，以查找截至 2015 年 8 月发表的报告生物活性玻璃治疗人类长骨感染结果的研究。
结果
三项研究共纳入 41 例患者，符合纳入标准。平均年龄为 46.5 岁（16 - 84 岁）。男性 29 例，女性 12 例。纳入时间为 2007 年至 2013 年。所有患者均经临床和影像学诊断为骨髓炎。他们均接受了治疗骨髓炎的先进外科手术。所有患者均植入 BAG - S53P4 颗粒（芬兰图尔库的 BonAlive Biomaterials Ltd）以填充 resulting 腔隙。平均植入体积为 16.8 毫升（2 - 60 毫升）。平均随访 21 个月（10 - 38 个月）后，3 例骨髓炎复发。其中 2 例进行了新的手术。未报告与生物活性玻璃直接相关的并发症。
讨论
尽管生物活性玻璃在人类长骨感染中的应用有限，但在彻底的骨清创和皮肤覆盖后，它似乎是一种有趣的骨替代物选择。它具有抗菌活性、骨传导特性和血管刺激作用。
结论
从本综述来看，生物活性玻璃似乎是治疗人类长骨感染的一种有用的骨替代物。使用后复发较少。在这些病例中，经常低估了要植入的骨玻璃体积和/或皮肤覆盖不充分。
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