Combined debridement, bone graft and articular cavity sealing using synovium in treating metaphyseal osteomyelitis involving knee joints
- Authors:
- Weiju Lu
- Gang Liu
- Bin Li
- Ningwen Shi
- Jianning Zhao
View Affiliations
Affiliations: Department of Orthopedic Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210002, P.R. China
- Published online on: October 25, 2012 https://doi.org/10.3892/etm.2012.762
-
Pages:
253-256
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Abstract
The aim of this study was to investigate the efficacy of combined debridement, bone graft and articular cavity sealing using synovium in the treatment of metaphyseal osteomyelitis involving the knee joint. Eleven patients with metaphyseal osteomyelitis, which involved femurs in 4 patients and tibiae in 7, were included. The patients received a novel treatment, which combined debridement, bone graft and articular cavity sealing using the synovium. Of the 11 patients, 4 patients with knee joint instability received a structural allograft and 7 with a stable knee joint underwent a particulate bone graft. The 11 patients underwent regular clinical and radiological evaluation; the average follow-up was 74 months (range, 58-96). Infection recurrence in the joint and bone graft area was not observed in 10 of the 11 cases. In one patient, who underwent a lateral granular cancellous bone allograft in the right tibial plateau, the infection recurred 2 weeks later in the graft area. The infection was arrested 3 months after re-debridement and a bilateral ilium bone graft to eliminate the dead space. Combined debridement, bone graft and articular cavity sealing using the synovium may be a feasible treatment for metaphyseal osteomyelitis involving the knee joint.
View References
|
1
|
Lew DP and Waldvogel FA: Osteomyelitis.
Lancet. 364:369–379. 2004. View Article : Google Scholar
|
|
2
|
Eckardt JJ, Wirganowicz PZ and Mar T: An
aggressive surgical approach to the management of chronic
osteomyelitis. Clin Orthop Relat Res. 298:229–239. 1994.PubMed/NCBI
|
|
3
|
Cierny G III, Mader JT and Penninck JJ: A
clinical staging system for adult osteomyelitis. Clin Orthop Relat
Res. 414:7–24. 2003. View Article : Google Scholar : PubMed/NCBI
|
|
4
|
Lazzarini L, Mader JT and Calhoun JH:
Osteomyelitis in long bones. J Bone Joint Surg Am. 86:2305–2318.
2004.
|
|
5
|
Garcia-Cimbrelo E and Marti-Gonzalez JC:
Circular external fixation in tibial nonunions. Clin Orthop Relat
Res. 419:65–70. 2004. View Article : Google Scholar
|
|
6
|
McKee MD, Yoo D and Schemitsch EH: Health
status after Ilizarov reconstruction of post-traumatic lower-limb
deformity. J Bone Joint Surg Br. 80:360–364. 1998. View Article : Google Scholar : PubMed/NCBI
|
|
7
|
Mekhail AO, Abraham E, Gruber B and
Gonzalez M: Bone transport in the management of posttraumatic bone
defects in the lower extremity. J Trauma. 56:368–378. 2004.
View Article : Google Scholar : PubMed/NCBI
|
|
8
|
Green SA: Skeletal defects: a comparison
of bone grafting and bone transport for segmental skeletal defects.
Clin Orthop Relat Res. 301:111–117. 1994.PubMed/NCBI
|
|
9
|
Sporer SM, O’Rourke M, Chong P and
Paprosky WG: The use of structural distal femoral allografts for
acetabular reconstruction: Average ten-year follow-up. J Bone Joint
Surg Am. 87:760–765. 2005.PubMed/NCBI
|
|
10
|
Sporer SM, O’Rourke M, Chong P and
Paprosky WG: The use of structural distal femoral allografts for
acetabular reconstruction: Surgical technique. J Bone Joint Surg
Am. 88(Suppl 1): 92–99. 2006.PubMed/NCBI
|
|
11
|
Schimmel JW, Buma P, Versleyen D, Huiskes
R and Slooff TJ: Acetabular reconstruction with impacted morselized
cancellous allografts in cemented hip arthroplasty: a histological
and biomechanical study on the goat. J Arthroplasty. 13:438–448.
1998. View Article : Google Scholar : PubMed/NCBI
|
|
12
|
Bolder SB, Schreurs BW, Verdonschot N,
Veth RP and Buma P: Wire mesh allows more revascularization than a
strut in impaction bone grafting: an animal study in goats. Clin
Orthop Relat Res. 423:280–286. 2004. View Article : Google Scholar : PubMed/NCBI
|
|
13
|
Cierny G III: Chronic osteomyelitis:
results of treatment. Instr Course Lect. 39:495–508. 1990.
|
|
14
|
Weiland AJ, Moore JR and Daniel RK: The
efficacy of free tissue transfer in the treatment of osteomyelitis.
J Bone Joint Surg Am. 66:181–193. 1984.PubMed/NCBI
|
|
15
|
McNally MA, Small JO, Tofighi HG and
Mollan RA: Two stage management of chronic osteomyelitis of the
long bones: the Belfast technique. J Bone Joint Surg Br.
75:375–380. 1993.PubMed/NCBI
|
