Chronic Tibial Osteomyelitis - Use of Biactive Glass as an Alternative of Treatment: Report of a Case

Avenamar Mora Zúñiga; Jair Eder Hernández Carrillo; Juan Daniel Cruz Munguía; Flavio Cárdenas Arellano

doi:doi:10.11648/j.cmr.20221103.18

| Peer-Reviewed

Chronic Tibial Osteomyelitis - Use of Biactive Glass as an Alternative of Treatment: Report of a Case

Avenamar Mora Zúñiga, Jair Eder Hernández Carrillo, Juan Daniel Cruz Munguía, Flavio Cárdenas Arellano

Published in Clinical Medicine Research (Volume 11, Issue 3)

Received: 24 May 2022 Accepted: 8 June 2022 Published: 20 June 2022

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: Chronic osteomyelitis is a disease usually of infectious origin. The main cause is post-traumatic, it affects the bone tissue and surrounding tissue, the most frequent causative agent is Staphylococcus aureus. The most affected bone is the tibia. Case description: A 42-year-old male with a diagnosis of chronic tibia osteomyelitis, with sequelae of previous surgical interventions, multiple antibiotic treatments, and type IV B classification by Cierny-Mader. Methods: Two-stage surgical management was chosen. Firstly, extensive bone and soft tissue debridement, placement of cement beads medicated with amikacin in the medullary cavity and osteoclast system for irrigation with vancomycin. In the second stage, free fibular bone grafting, fixation and stabilization with screws, bioactive glass placement in areas of interface between stabilized fibula and posterior tibial cortex. Results: Before a multitratada chronic osteomyelitis it is necessary to individualize and evaluate treatment alternatives, in this case the surgical management in two time, the use of medication beads, bone graft and the use of bioactive glass, achieved a complete eradication of the infection and favorable clinical evolution with optimal functional recovery of affected limb.

Published in	Clinical Medicine Research (Volume 11, Issue 3)
DOI	10.11648/j.cmr.20221103.18
Page(s)	88-91
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Chronic Osteomyelitis, Tibia, Bioactive Glass

References

[1]	Ifeanyi I, Vipul Savaliya. Osteomyelitis. StatPearls. 27 de octubre 2018. Disponible: https://www.ncbi.nlm.nih.gov/pubmed/30335283
[2]	Hatzenbuehler J, Pulling TJ. Diagnosis and Management of Osteomyelitis. American Family Physician. 2011; 84 (9): 1027-1033.
[3]	Kusma J, Hombhanje F. Chronic Osteomyelitis - Bacterial Flora, Antibiotic Sensitivity and Treatment Challenges. The Open Orthopaedics Journal. 2018; 12: 153-163.
[4]	Kinik H, Karaduman M. Cierny-Mader Type III chronic osteomyelitis: the results of patients treated with debridement, irrigation, vancomycin beads and systemic antibiotics. International Orthopaedics. 2008; 32: 551–558.
[5]	Garcia E, Collazos J, Carton JA, Camporro D, Asensi V. Bacterial osteomyelitis: microbiological, clinical, therapeutic, and evolutive characteristics of 344 episodes. Spanish Society of Chemotherapy. 2018; 31 (3): 217-225.
[6]	Maradit H, Macaulay E, Jeanine E, Wood C, Melton J, Huddleston PM. Trends in the Epidemiology of Osteomyelitis A Population-Based Study, 1969 to 2009. The Journal of Bone and Joint Surgery. 2015; 97: 837- 45.
[7]	Ouedraogo S, Zida M, Tall M. Aspects épidémiologiques, bactériologiques et thérapeutiques des ostéomyélites chroniques en milieu subsaharien. Medecine et Sante Tropicales. 2017; 27: 292-295.
[8]	Nan J, Yun-Fei M, Xing-qi Z, Guo-ping X, Yan-jun H, Cheng-he Q, et al. Clinical Characteristics and Treatment of Extremity Chronic Osteomyelitis in Southern China. Medicine Jorunal. 2015; 94 (42): 1-7.
[9]	Spellberg B, Lipsky B. Systemic Antibiotic Therapy for Chronic Osteomyelitis in Adults. Clinical Practice. 2012; 54: 393 – 407.
[10]	Emara Khaled M. Hemi-corticotomy in the management of chronic osteomyelitis of the tibia. International Orthopaedics. 2002; 26: 310-313.
[11]	Walter G, Jemmerer M, Kappler C, Hoffmann R. Treatment Algorithms for Chronic Osteomyelitis. Deutsches Arzteblatt International. 2012; 109 (14): 257- 264.
[12]	Yashavantha K, Nalini B, Jagdish M, Dilip K, Banerji B. Calcium Sulfate as Bone Graft Substitute in the Treatment of Osseous Bone Defects, A Prospective Study. Journal of Clinical and Diagnostic Research. 2013; 7 (12): 2926-2928.
[13]	Oonishi H, Hench L, Wilson J, Sugihara F, Tsuji E, Matsuura M. et al. Quantitative comparison of bone growth behavior in granules of Bioglass, A-W glass-ceramic, and hydroxyapatite. Journal of biomedical materials research. 2000; 51 (1): 37- 46.
[14]	Rizwan M, Hamdi M, Basirun W. Bioglas 45S5 Based Composites for Bone Tissue Engineering and Funtional Applications. Journal of biomedicals materials. 2017; 105 (11): 3197-3223.
[15]	Calori G, Mazza E, Colombo M, Ripamoti C. The use of bone-graft substitutes in large bone defects: Any specific needs?. International journal of the Care of the Injured. 2011; 42: S56-S63.
[16]	Mckee M, Wild L, Schemitsch E, Waddell J. The Use of an Antibiotic-Impregnated, Osteoconductive, Bioabsorbable Bone Substitute in the Treatment of Infected Long Bone Defects: Early Results of a Prospective Trial. Journal of Orthopaedic Trauma. 2002; 16 (9): 622-627.
[17]	Lindfors N, Geurts J, Drago L, Arts J, Juutilainen V, Huvonen P, et al. Antibacterial bioactive glass, S53P4, for chronic bone infections – A multinational study. Advances in esperimental medicine and biology. 2017; 971: 81-92.
[18]	Gestel N, Geurts J, Hulsen D, Rietbergen B, Hofmann S. Clinical Applications of S53P4 Bioactive Glass in Bone Healing. Biomed Research International. 2015; 2015: 1-12.
[19]	Auregan J, Begue T. Bioactive glass long bone infection: a systematic review. International Journal of the Care of the Injured. 2015; 46: S3-S7.
[20]	Lindfors N, Hyvonen P, Nyyssonen M, Kirjavainen M, Kankare J, Gullichsen E, et al. Bioactive glass S53P4 as bone graft substitute in treatment of osteomyelitis. Bone. 2010; 47 (2): 212-218.
[21]	Ferrando A, Part J, Baeza J. Treatment of cavitary bone defects in chronic osteomyelitis: Bioactive glass S53P4 vs Calcium sulphate antibiotic beads. Journal of Bone and Joint Infection. 2017; 2 (4): 194-201.
[22]	Drago L, Romano D, Vecchi E, Vassena C, Logoluso N, Mattina R, et al. Bioactive glass BAG-S53P4 for the adjunctive treatment of chronic osteomyelitis of the long bones: an in vitro and prospective clinical study. BCM Infectious Diseases. 2013; 10: 584.
[23]	Humm G, Noor s, Brirgeman P, David M, Bose D. Adjuvant treatmen of chronic osteomyelitis of the tibia following exogenous trauma using OSTEOSET –T: a review of 21 patients in a regional trauma centre. Strat Traum Limb Recon. 2014; 9: 157-161.
[24]	Romano C, Logoluso N, Meani E, Romano D, Vecchi E, Vassena, et al. A comparative study of the use of bioactive glass S53P4 abd antibiotic-loaded calcium-based bone substitutes inthe treatment of chronic osteomyelitis. The Bone and Joint Journal. 2014; 96 (B): 845-850.

Cite This Article

Plain Text BibTeX RIS

APA Style

Avenamar Mora Zúñiga, Jair Eder Hernández Carrillo, Juan Daniel Cruz Munguía, Flavio Cárdenas Arellano. (2022). Chronic Tibial Osteomyelitis - Use of Biactive Glass as an Alternative of Treatment: Report of a Case. Clinical Medicine Research, 11(3), 88-91. https://doi.org/10.11648/j.cmr.20221103.18

Copy | Download

ACS Style

Avenamar Mora Zúñiga; Jair Eder Hernández Carrillo; Juan Daniel Cruz Munguía; Flavio Cárdenas Arellano. Chronic Tibial Osteomyelitis - Use of Biactive Glass as an Alternative of Treatment: Report of a Case. Clin. Med. Res. 2022, 11(3), 88-91. doi: 10.11648/j.cmr.20221103.18

Copy | Download

AMA Style

Avenamar Mora Zúñiga, Jair Eder Hernández Carrillo, Juan Daniel Cruz Munguía, Flavio Cárdenas Arellano. Chronic Tibial Osteomyelitis - Use of Biactive Glass as an Alternative of Treatment: Report of a Case. Clin Med Res. 2022;11(3):88-91. doi: 10.11648/j.cmr.20221103.18

Copy | Download

@article{10.11648/j.cmr.20221103.18,
  author = {Avenamar Mora Zúñiga and Jair Eder Hernández Carrillo and Juan Daniel Cruz Munguía and Flavio Cárdenas Arellano},
  title = {Chronic Tibial Osteomyelitis - Use of Biactive Glass as an Alternative of Treatment: Report of a Case},
  journal = {Clinical Medicine Research},
  volume = {11},
  number = {3},
  pages = {88-91},
  doi = {10.11648/j.cmr.20221103.18},
  url = {https://doi.org/10.11648/j.cmr.20221103.18},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20221103.18},
  abstract = {Background: Chronic osteomyelitis is a disease usually of infectious origin. The main cause is post-traumatic, it affects the bone tissue and surrounding tissue, the most frequent causative agent is Staphylococcus aureus. The most affected bone is the tibia. Case description: A 42-year-old male with a diagnosis of chronic tibia osteomyelitis, with sequelae of previous surgical interventions, multiple antibiotic treatments, and type IV B classification by Cierny-Mader. Methods: Two-stage surgical management was chosen. Firstly, extensive bone and soft tissue debridement, placement of cement beads medicated with amikacin in the medullary cavity and osteoclast system for irrigation with vancomycin. In the second stage, free fibular bone grafting, fixation and stabilization with screws, bioactive glass placement in areas of interface between stabilized fibula and posterior tibial cortex. Results: Before a multitratada chronic osteomyelitis it is necessary to individualize and evaluate treatment alternatives, in this case the surgical management in two time, the use of medication beads, bone graft and the use of bioactive glass, achieved a complete eradication of the infection and favorable clinical evolution with optimal functional recovery of affected limb.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Chronic Tibial Osteomyelitis - Use of Biactive Glass as an Alternative of Treatment: Report of a Case
AU  - Avenamar Mora Zúñiga
AU  - Jair Eder Hernández Carrillo
AU  - Juan Daniel Cruz Munguía
AU  - Flavio Cárdenas Arellano
Y1  - 2022/06/20
PY  - 2022
N1  - https://doi.org/10.11648/j.cmr.20221103.18
DO  - 10.11648/j.cmr.20221103.18
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 88
EP  - 91
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20221103.18
AB  - Background: Chronic osteomyelitis is a disease usually of infectious origin. The main cause is post-traumatic, it affects the bone tissue and surrounding tissue, the most frequent causative agent is Staphylococcus aureus. The most affected bone is the tibia. Case description: A 42-year-old male with a diagnosis of chronic tibia osteomyelitis, with sequelae of previous surgical interventions, multiple antibiotic treatments, and type IV B classification by Cierny-Mader. Methods: Two-stage surgical management was chosen. Firstly, extensive bone and soft tissue debridement, placement of cement beads medicated with amikacin in the medullary cavity and osteoclast system for irrigation with vancomycin. In the second stage, free fibular bone grafting, fixation and stabilization with screws, bioactive glass placement in areas of interface between stabilized fibula and posterior tibial cortex. Results: Before a multitratada chronic osteomyelitis it is necessary to individualize and evaluate treatment alternatives, in this case the surgical management in two time, the use of medication beads, bone graft and the use of bioactive glass, achieved a complete eradication of the infection and favorable clinical evolution with optimal functional recovery of affected limb.
VL  - 11
IS  - 3
ER  -

Copy | Download

Author Information

Avenamar Mora Zúñiga
Jair Eder Hernández Carrillo

Family Medicine Department, Michoacán University of San Nicolás de Hidalgo, Morelia Michoacán, Mexico
Juan Daniel Cruz Munguía

Department of Internal Medicine, Universidad Michoacana de San Nicolás de Hidalgo, Morelia Michoacán, Mexico
Flavio Cárdenas Arellano

Department of Anesthesiology, Universidad Michoacana de San Nicolás de Hidalgo, Morelia Michoacán, Mexico

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Avenamar Mora Zúñiga, Jair Eder Hernández Carrillo, Juan Daniel Cruz Munguía, Flavio Cárdenas Arellano. (2022). Chronic Tibial Osteomyelitis - Use of Biactive Glass as an Alternative of Treatment: Report of a Case. Clinical Medicine Research, 11(3), 88-91. https://doi.org/10.11648/j.cmr.20221103.18

Copy | Download

ACS Style

Avenamar Mora Zúñiga; Jair Eder Hernández Carrillo; Juan Daniel Cruz Munguía; Flavio Cárdenas Arellano. Chronic Tibial Osteomyelitis - Use of Biactive Glass as an Alternative of Treatment: Report of a Case. Clin. Med. Res. 2022, 11(3), 88-91. doi: 10.11648/j.cmr.20221103.18

Copy | Download

AMA Style

Avenamar Mora Zúñiga, Jair Eder Hernández Carrillo, Juan Daniel Cruz Munguía, Flavio Cárdenas Arellano. Chronic Tibial Osteomyelitis - Use of Biactive Glass as an Alternative of Treatment: Report of a Case. Clin Med Res. 2022;11(3):88-91. doi: 10.11648/j.cmr.20221103.18

Copy | Download

@article{10.11648/j.cmr.20221103.18,
  author = {Avenamar Mora Zúñiga and Jair Eder Hernández Carrillo and Juan Daniel Cruz Munguía and Flavio Cárdenas Arellano},
  title = {Chronic Tibial Osteomyelitis - Use of Biactive Glass as an Alternative of Treatment: Report of a Case},
  journal = {Clinical Medicine Research},
  volume = {11},
  number = {3},
  pages = {88-91},
  doi = {10.11648/j.cmr.20221103.18},
  url = {https://doi.org/10.11648/j.cmr.20221103.18},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20221103.18},
  abstract = {Background: Chronic osteomyelitis is a disease usually of infectious origin. The main cause is post-traumatic, it affects the bone tissue and surrounding tissue, the most frequent causative agent is Staphylococcus aureus. The most affected bone is the tibia. Case description: A 42-year-old male with a diagnosis of chronic tibia osteomyelitis, with sequelae of previous surgical interventions, multiple antibiotic treatments, and type IV B classification by Cierny-Mader. Methods: Two-stage surgical management was chosen. Firstly, extensive bone and soft tissue debridement, placement of cement beads medicated with amikacin in the medullary cavity and osteoclast system for irrigation with vancomycin. In the second stage, free fibular bone grafting, fixation and stabilization with screws, bioactive glass placement in areas of interface between stabilized fibula and posterior tibial cortex. Results: Before a multitratada chronic osteomyelitis it is necessary to individualize and evaluate treatment alternatives, in this case the surgical management in two time, the use of medication beads, bone graft and the use of bioactive glass, achieved a complete eradication of the infection and favorable clinical evolution with optimal functional recovery of affected limb.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Chronic Tibial Osteomyelitis - Use of Biactive Glass as an Alternative of Treatment: Report of a Case
AU  - Avenamar Mora Zúñiga
AU  - Jair Eder Hernández Carrillo
AU  - Juan Daniel Cruz Munguía
AU  - Flavio Cárdenas Arellano
Y1  - 2022/06/20
PY  - 2022
N1  - https://doi.org/10.11648/j.cmr.20221103.18
DO  - 10.11648/j.cmr.20221103.18
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 88
EP  - 91
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20221103.18
AB  - Background: Chronic osteomyelitis is a disease usually of infectious origin. The main cause is post-traumatic, it affects the bone tissue and surrounding tissue, the most frequent causative agent is Staphylococcus aureus. The most affected bone is the tibia. Case description: A 42-year-old male with a diagnosis of chronic tibia osteomyelitis, with sequelae of previous surgical interventions, multiple antibiotic treatments, and type IV B classification by Cierny-Mader. Methods: Two-stage surgical management was chosen. Firstly, extensive bone and soft tissue debridement, placement of cement beads medicated with amikacin in the medullary cavity and osteoclast system for irrigation with vancomycin. In the second stage, free fibular bone grafting, fixation and stabilization with screws, bioactive glass placement in areas of interface between stabilized fibula and posterior tibial cortex. Results: Before a multitratada chronic osteomyelitis it is necessary to individualize and evaluate treatment alternatives, in this case the surgical management in two time, the use of medication beads, bone graft and the use of bioactive glass, achieved a complete eradication of the infection and favorable clinical evolution with optimal functional recovery of affected limb.
VL  - 11
IS  - 3
ER  -

Copy | Download