Antibacterial Bioactive Glass, S53P4, for Chronic Bone Infections – A Multinational Study

Abstract

Osteomyelitis is an infectious process in bone that occasionally leads to bone destruction. Traditionally, the surgical treatment procedure is performed in combination with systemic and local antibiotics as a two-stage procedure that uses autograft or allograft bone for filling of the cavitary defect. Bioactive glass (BAG-S53P4) is a bone substitute with proven antibacterial and bone bonding properties.One hundred and sixteen patients who had verified chronic osteomyelitis was treated using BAG-S53P4 as part of the treatment. Most of the patients had previously undergone numerous procedures, sometimes for decades. A register of patient data obtained from 11 centers from Finland, Italy, the Netherlands, Germany, Azerbaijan and Poland was set-up and continuously maintained at Helsinki University Central Hospital.The location of the osteomyelitis was mainly in the tibia followed by the femur and then the calcaneus. The median age of the patients was 48 years (15-87). The patients were either treated according to a one-stage procedure without local antibiotics (85 %) or by a two-stage procedure using antibiotic beads in the first procedure (15 %). The minimum follow-up was 1 year (12-95 months, median 31).The cure rate was 104/116, the total success rate 90 % and most of the patients showed a rapid recovery.The study shows that (BAG-S53P4) can be used in a one-stage procedure in treatment of osteomyelitis with excellent results.

Influence of bioactive glass S53P4 granules and putty on osteomyelitis associated bacteria in vitro

“…BAG S53P4 has been studied clinically in randomised prospective trials in bone tumour [27,28], trauma [29] and spine surgery [30,31]. Due to its antibacterial properties is has also been used in the treatment of severe chronic osteomyelitis, mastoiditis, spine infections and frontal sinus infections [21,[32][33][34][35][36][37][38].…”

Surface modification of valve metals using plasma electrolytic oxidation for antibacterial applications: A review

“…Osteomyelitis is a damaging inflammatory process for bone, which results from microorganism (most importantly MRSA) infection, which may lead to bone destruction. These clinical trials suggest that bone substitutes made of BG S53P4 can treat Osteomyelitis efficiently due to its strong antibacterial characteristic . Table describes the antibacterial behavior of selected BGs.…”

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“…In a study of 116 chronic osteomyelitis patients treated with antibacterial bioglass, S53P4, 90% of the patients were infection free after a median follow-up of 31 months [20]. In another study where vancomycin was loaded onto borate bioglass pellets in vitro drug release above the minimum inhibitory concentration (MIC) was observed for up to 18 days.…”