Tanpure Sanket, Kharat Sagar, Keluskar Chintamani, Yadav Sunil, Yadav Vinod, Sonawane Akash
Department of Orthopaedics, New Thergaon Hospital, Pune, Maharashtra, India.
Department of Orthopaedics, KBBH Hospital, Mumbai, Maharashtra, India.
J Orthop Case Rep. 2024 Aug;14(8):125-129. doi: 10.13107/jocr.2024.v14.i08.4672.
Adult cases of septic arthritis due to concomitant persistent osteomyelitis are incredibly uncommon. This study describes a rare example of septic arthritis in an adult's knee joint caused by long-term femur osteomyelitis. A cement rod laced with antibiotics proved to be an effective treatment for the illness.
A case of septic knee arthritis caused by reactivated chronic osteomyelitis is described in this study. Initial radiographs revealed an osteolytic lesion, prompting further imaging, including a magnetic resonance imaging, which verified the diagnosis. To treat the infected intra-articular knee joint and ream the femoral intramedullary canal, we chose open debridement over arthroscopic surgery based on the patient's history, physical examination, and imaging data. To close the dead space and remove the infection, a cement rod impregnated with antibiotics was placed into the medullary cavity, in addition to administering long-term antibiotic treatment. This approach was successful in eradicating the infection. Following a period of rehabilitation, the patient regained the ability to walk independently.
Cement rods infused with antibiotics are effective for delivering high doses of antibiotics locally while providing structural support to the bone. Over the last three decades, they have demonstrated encouraging outcomes in treating infections, and due to their affordability, simplicity, and effectiveness, they remain an excellent treatment option. Here, we highlight the use of colistin in making antibiotic-coated cement rods for the eradication of chronic, long-standing infection.
成人因合并持续性骨髓炎导致的化脓性关节炎病例极为罕见。本研究描述了一例由长期股骨骨髓炎引起的成人膝关节化脓性关节炎的罕见病例。事实证明,一根浸有抗生素的骨水泥棒是治疗该疾病的有效方法。
本研究描述了一例由复发性慢性骨髓炎引起的膝关节化脓性关节炎病例。最初的X线片显示有溶骨性病变,促使进一步进行影像学检查,包括磁共振成像,从而证实了诊断。根据患者的病史、体格检查和影像学数据,我们选择开放性清创术而非关节镜手术来治疗感染的膝关节内关节并扩髓股骨髓腔。除了进行长期抗生素治疗外,还将一根浸有抗生素的骨水泥棒放入髓腔以封闭死腔并消除感染。这种方法成功地根除了感染。经过一段时间的康复,患者恢复了独立行走的能力。
浸有抗生素的骨水泥棒在局部提供高剂量抗生素的同时,还能为骨骼提供结构支撑,效果显著。在过去三十年中,它们在治疗感染方面显示出令人鼓舞的结果,并且由于其价格低廉、操作简单且效果显著,仍然是一种出色的治疗选择。在此,我们强调使用黏菌素制作抗生素涂层骨水泥棒以根除慢性、长期感染。