Antibiotic-loaded bone cement spacer usage combined with membrane induction in infected gap non-unions: A case series

Abstract

Objective:To explore the clinical effects upon gap nonunion of antibiotic-loaded bone cement spacer combined with membrane induction on infected bone defects.Methods:The data of 16 patients with infected bone defects admitted in General Hospital of Shenyang Military Area Command from January 2009 to January 2011 were analyzed retrospectively. There were 12 males and 4 females aged between 24-63 years age (average 43.1 ± 9.7) who had received antibiotic laiden bone cement spacer treatment. Stage-1, debridement and anti-biotic treatment with intraoperative preparation of customized bone cement spacers (antibiotics and bone cement spacer) with or without internal or external fixation Stage-2, removal of spacer and repair of bone defects using membrane-induced technique and internal fixation at bone defects site.Results:Sixteen patients were followed up for 39-98 months, (67.2 ± 20.4) on average. All patients with infected bone defects were healed. X-ray showed that fractures had healed and the new bone formed at graft site was more radio opaque than that of adjacent bone segments. The healing time was 6 to 10 months, (7.4 ± 1.1) on average. There was no recurrence of infection or deformity.Conclusion:The antibiotic-loaded cement spacer can control the local infection while maintaining the limb length and increasing the stability, reducing the contracture of bone and soft tissue, creating conditions for subsequent repair and reducing the infection rate of bone defects.

A Systematic Review and Meta-Analysis of Combined Antibiotic Spacer with Ilizarov Methods in the Treatment of Infected Nonunion of Tibia

“…Moreover, bone cement can provide local support and facilitate early functional exercise [ 28 ], although there is no standard for the use of antibiotics in bone cement, because excessive addition will reduce the mechanical strength. But a study found that adding 8 grams of antibiotics to 40 grams of bone cement is still safe [ 29 ].…”