Comment on “Bioactive glass S53P4 vs. autologous bone graft for filling defects in patients with chronic osteomyelitis and infected non-unions – a single  center  experience” by Steinhausen et al. (2021)

McNally, Martin

doi:10.5194/jbji-6-199-2021

Cited by 3 publications

(3 citation statements)

References 20 publications

(18 reference statements)

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“…Its use resulted in long-lasting drainage of white fluid like the liquefied bone substitute in most of our patients. This phenomenon of increased drainage of white fluid is also described by other authors using this bone substitute (Drampalos et al, 2019;Pesch et al, 2020).…”

supporting

confidence: 80%

Reply to McNally's comment on “Bioactive glass S53P4 vs. autologous bone graft for filling defects in patients with chronic osteomyelitis and infected non-unions – a single center experience” by Steinhausen et al. (2021)

Steinhausen

Lefering

Glombitza

et al. 2021

J. Bone Joint Infect.

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supporting

confidence: 80%

Reply to McNally's comment on “Bioactive glass S53P4 vs. autologous bone graft for filling defects in patients with chronic osteomyelitis and infected non-unions – a single center experience” by Steinhausen et al. (2021)

Steinhausen

Lefering

Glombitza

et al. 2021

J. Bone Joint Infect.

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“…This reinforces that patients with open fractures and persistent low-grade infections have a poorer outcome. A similar conclusion was drawn when using BaG stand alone in cases of infected non-unions, where BaG exhibited a high rate of reinfection as well [32]. In a retrospective single-center study, Steinhausen et al reported on the treatment of 50 patients with chronic osteomyelitis and infected non-unions, using BaG (46 cases) and in combination with autologous bone (4 cases).…”

Section: Discussionmentioning

confidence: 65%

“…In a retrospective single-center study, Steinhausen et al reported on the treatment of 50 patients with chronic osteomyelitis and infected non-unions, using BaG (46 cases) and in combination with autologous bone (4 cases). They observed a higher reinfection rate in the BaG-treated group, with Staphylococcus aureus being the most common pathogen identified [32]. In the mentioned study, BaG mono without autologous cancellous bone was predominantly used in the majority of cases, making the results not directly applicable to ours.…”

Section: Discussionmentioning

confidence: 66%

Use of Autologous Bone Graft with Bioactive Glass as a Bone Substitute in the Treatment of Large-Sized Bone Defects of the Femur and Tibia

Findeisen,

Gräfe,

Schwilk

et al. 2023

JPM

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Background: Managing bone defects in non-union surgery remains challenging, especially in cases of large defects exceeding 5 cm in size. Historically, amputation and compound osteosynthesis with a remaining PMMA spacer have been viable and commonly used options. The risk of non-union after fractures varies between 2% and 30% and is dependent on various factors. Autologous bone grafts from the iliac crest are still considered the gold standard but are limited in availability, prompting consideration of artificial grafts. Objectives: The aims and objectives of the study are as follows: 1. To evaluate the radiological outcome of e.g., the consolidation and thus the stability of the bone (three out of four consolidated cortices/Lane-Sandhu-score of at least 3) by using S53P4-type bioactive glass (BaG) as a substitute material for large-sized bone defects in combination with autologous bone using the RIA technique. 2. To determine noticeable data-points as a base for future studies. Methods: In our clinic, 13 patients received bioactive glass (BaG) as a substitute in non-union therapy to promote osteoconductive aspects. BaG is a synthetic material composed of sodium, silicate, calcium, and phosphate. The primary endpoint of our study was to evaluate the radiological consolidation of bone after one and two years. To assess bone stabilization, we used a modified Lane-Sandhu score, considering only radiological criteria. A bone was considered stabilized if it achieved a minimum score of 3. For full consolidation (all four cortices consolidated), a minimum score of 4 was required. Each bone defect exceeded 5 cm in length, with an average size of 6.69 ± 1.92 cm. Results: The mean follow-up period for patients without final bone consolidation was 34.25 months, with a standard deviation of 14.57 months, a median of 32.00 months and a range of 33 months. In contrast, patients with a fully consolidated non-union had an average follow-up of 20.11 ± 15.69 months and a range of 45 months. Overall, the mean time from non-union surgery to consolidation for patients who achieved final union was 14.91 ± 6.70 months. After one year, six patients (46.2%) achieved complete bone consolidation according to the Lane-Sandhu score. Three patients (23.1%) displayed evident callus formation with expected stability, while three patients (23.1%) did not develop any callus, and one patient only formed a minimal callus with no expected stability. After two years, 9 out of 13 patients (69.2%) had a score of 4. The remaining four patients (30.8%) without expected stability either did not heal within two years or required a revision during that time. Conclusions: Bioactive glass (BaG) in combination with autologous bone (RIA) appears to be a suitable filler material for treating extensive non-unions of the femur and tibia. This approach seems to show non-inferiority to treatment with Tricalcium Phosphate (TCP). To ensure the success of this treatment, it is crucial to validate the procedure through a randomized controlled trial (RCT) with a control group using TCP, which would provide higher statistical power and more reliable results.

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Advances in Regenerative and Reconstructive Medicine in the Prevention and Treatment of Bone Infections

Dantas,

Ortis,

Suss

et al. 2024

Biology

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Reconstructive and regenerative medicine are critical disciplines dedicated to restoring tissues and organs affected by injury, disease, or congenital anomalies. These fields rely on biomaterials like synthetic polymers, metals, ceramics, and biological tissues to create substitutes that integrate seamlessly with the body. Personalized implants and prosthetics, designed using advanced imaging and computer-assisted techniques, ensure optimal functionality and fit. Regenerative medicine focuses on stimulating natural healing mechanisms through cellular therapies and biomaterial scaffolds, enhancing tissue regeneration. In bone repair, addressing defects requires advanced solutions such as bone grafts, essential in medical and dental practices worldwide. Bovine bone scaffolds offer advantages over autogenous grafts, reducing surgical risks and costs. Incorporating antimicrobial properties into bone substitutes, particularly with metals like zinc, copper, and silver, shows promise in preventing infections associated with graft procedures. Silver nanoparticles exhibit robust antimicrobial efficacy, while zinc nanoparticles aid in infection prevention and support bone healing; 3D printing technology facilitates the production of customized implants and scaffolds, revolutionizing treatment approaches across medical disciplines. In this review, we discuss the primary biomaterials and their association with antimicrobial agents.

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Comment on “Bioactive glass S53P4 vs. autologous bone graft for filling defects in patients with chronic osteomyelitis and infected non-unions – a single center experience” by Steinhausen et al. (2021)

Cited by 3 publications

References 20 publications

Reply to McNally's comment on “Bioactive glass S53P4 vs. autologous bone graft for filling defects in patients with chronic osteomyelitis and infected non-unions – a single center experience” by Steinhausen et al. (2021)

Reply to McNally's comment on “Bioactive glass S53P4 vs. autologous bone graft for filling defects in patients with chronic osteomyelitis and infected non-unions – a single center experience” by Steinhausen et al. (2021)

Use of Autologous Bone Graft with Bioactive Glass as a Bone Substitute in the Treatment of Large-Sized Bone Defects of the Femur and Tibia

Advances in Regenerative and Reconstructive Medicine in the Prevention and Treatment of Bone Infections

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