Role of Biodegradable Cement in Musculoskeletal Infection in the Pediatric Population
Volume 9 | Issue 2 | May-August 2023 | Page: 16-20 | Cury Sharma, Vivek Singh, Aditya Gowda, Parshwanath Bondarde, Naveen Kumar, Ch Sri Madhusudhan, Vikas Maheshwari
DOI- https://doi.org/10.13107/ijpo.2023.v09.i02.166
Submitted: 14/12/2022; Reviewed: 17/02/2023; Accepted: 20/06/2023; Published: 18/08/2023
Authors: Cury Sharma MS Ortho [1], Vivek Singh MS Ortho [1], Aditya Gowda MS Ortho [1], Parshwanath Bondarde MBBS [2], Naveen Kumar MS Ortho, MCH Paediatric Orthopaedics [1], Ch Sri Madhusudhan MBBS [2], Vikas Maheshwari MS Ortho [1]
[1] Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
[2] MBBS, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Address of Correspondence
Dr. Vivek Singh
Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
E-mail: singhvr27@gmail.com
Abstract
Introduction: Chronic osteomyelitis presents a significant challenge when it comes to treatment in children. Despite thorough radical debridement and extended antibiotic courses, it often proves resistant to resolution. The literature lacks definitive guidelines on the optimal management of chronic osteomyelitis, leaving several unanswered questions.
Patients and methods: The study comprised all patients who underwent surgery in the year 2022. After clinical history, examination, radiological studies, and blood investigations; single stage debridement and bone cement beads application was performed and patients were followed up for a period of 12 months.
Result: Eighteen patients (12 males and 6 females) with a mean age 6 years requiring surgical debridement were included in the study. Involved bones were tibia (12%), ulna (6%), humerus (6%), and femur (76%). Erythrocyte sedimentation rate (ESR) normalized in a mean time of 2.3 months and C-reactive protein (CRP) normalised in a mean time of 2.3 weeks. The average duration of infection prior to treatment was 5.6 months (Table 2). The most common organism isolated was Methicillin resistant Staphylococcus aureus (MRSA) (Table 4) and most common antibiotic sensitivity found was with Linezolid (58%) followed by Vancomycin (41%). Mean bone healing time radiologically was 3.3 months and mean cement absorption time was 2.6 months.
At 1 year follow up, all patients had healing both clinically and radiologically. There was reactivation of infection in 1 patient that settled with antibiotic therapy only. None of the children in the series required reoperation for infection.o signs of relapse at 1 year follow up and 0 percent – reoperation.
Conclusion: The addition of biodegradable cement increases the rate of eradication of infection during treatment of chronic osteomyelitis in children. Antibiotic course should be continued until the ESR and CRP normalise with an initial short intravenous course.
Keywords: Chronic osteomyelitis, Stimulan, Paediatric
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| How to Cite this Article: Sharma C, Singh V, Gowda A, Bondarde P, Kumar N, Srimadhusudhan C, Maheshwari V | Role of Biodegradable Cement in Musculoskeletal Infection in the Pediatric Population | International Journal of Paediatric Orthopaedics | May-August 2023; 9(2): 16-20. https://doi.org/10.13107/ijpo.2023.v09.i02.166 |
