The kinetics of drug release from fibrin adhesive agent (consisting of fibrinogen, factor 8, thrombin, aportinin and calcium chloride)-antibiotic compound and efficacy on rat experimental osteomyelitis were studied. To enhance the slow release activities of antibiotic, a mixture of fibrin clots was freeze-dried. Effects of freeze-drying were to make a fibrin clot an interlinked pore and to increase crosslinking rate containing an antibiotic. A diffusion test from aminoglycoside (Arbekacin Sulfate: 200 mg) compound was carried out. In vitro study freeze-dried antibiotic compound (FFAC: 1 cm3) was placed in saline (3 ml). The saline was replaced every 48 h and the previous solution was stored at -45 degrees C until assay. The result was that a concentration of 0.4 mg/l, sufficiently high to control Staphylococcus aureus strain IM2-42, was maintained within nine exchanges of saline after 18 days. In vivo animal experiments, FFAC (2 x 2 x 3 mm) were tested in rats with established Staphylococcus aureus osteomyelitis in the proximal tibia. The animals were observed for radiographic signs of infection and tissue was examined histopathologically. Bacterial counts by bone cultures were statistically lower in rats implanted with FFAC than in those only given a drug-free FFC and curettage. Radiographical and histological observations also showed beneficial effects of the FFAC. The results suggest that the FFAC provide a simple drug delivery system, and may be a promising alternative treatment for osteomyelitis.
Background: To explore the role of nickel-titanium(NiTi) shape memory alloy embracing fixator in determination of implantation angle of hip tumor prosthesis stem and analyze its efficacy. Methods: 36 patients with proximal femur tumor were treated with extended tumor resection and prosthetic replacement. 14 patients received prosthetic replacements with the embracing fixators fixing between the junction of the prosthesis stem and the femur temporarily, while the other 22 patients received the same replacements but without the fixators. Following aspects were compared: occurrence of complications, limb function and active hip ROM.Results: There are fewer cases of hip dislocation in the group received prosthetic replacements with the use of embracing fixators. Occurrence of deep infection presented no difference between the two groups. Better limb function and higher active range of motion (ROM) on abduction or flexion were also found in the group using embracing fixators. Conclusion: Ni-Ti shape memory alloy embracing fixator plays a key part in assisting the accurate implantation angle of the prosthesis stem in the prosthetic replacement. The prosthesis stem can be adjusted to the optimal angle with the help of the embracing fixator. Patients have lower chance of dislocation, better limb function, and higher active hip ROM. Trial registration: retrospectively registered.
We report an unusual case of a giant femoral abscess caused by postoperative osteomyelitis after treating a fracture of the femoral shaft. The patient ignored it until the abscess began to interfere with knee flexion, but no symptoms of inflammation such as fever, pain or abnormal laboratory values were found. Within the marrow cavity, many plasma cells produced immunoglobulins G and M, and the level of these substances in the abscess fluid connected to the bony focus were higher than the serum levels. It was concluded that the inflammation in this case signified a peculiarity in a primarily chronic process.
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