Fluorescent tetracycline bone labeling as an intraoperative tool to debride necrotic  bone during septic hip revision: a preliminary case series

Muñoz-Mahamud, Ernesto; Fernández-Valencia, Jenaro Á.; Combalía, A.; Morata, Laura; Soriano, Álex

doi:10.5194/jbji-6-85-2021

Cited by 5 publications

(2 citation statements)

References 17 publications

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“…The level of resection was decided intraoperatively based on macroscopic bone findings. We did not use any other system to decide the level of resection, neither the intraoperative bone frozen section [19,20] nor the fluorescent tetracycline bone labeling [21].…”

Section: Discussionmentioning

confidence: 99%

One-Stage Hip Revision Arthroplasty Using Megaprosthesis in Severe Bone Loss of The Proximal Femur Due to Radiological Diffuse Osteomyelitis

2021

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Managing substantial proximal and/or distal femoral bone defects is one of the biggest challenges in chronic hip periprosthetic joint infection. Most authors use two-stage arthroplasty with a temporary antibiotic-loaded cement spacer for the management of these patients. In this study, we show our experience with one-stage exchange arthroplasty in managing severe bone defects due to radiological-extensive proximal femoral osteomyelitis. Two patients were included in the study. They showed radiological-extensive proximal femoral osteomyelitis, and they were treated with one-stage exchange arthroplasty using megaprosthesis. Diffuse osteomyelitis was confirmed in both cases; in one case, the histology was compatible with osteomyelitis, and the other case had a positive culture identified in a bone sample. At a minimum of a four-year follow-up, the patients did not reveal any clinical, radiological or laboratory signs of infection. In conclusion, one-stage exchange arthroplasty and megaprosthesis is an option for the treatment of chronic hip periprosthetic joint infection associated with radiological-diffuse proximal femoral osteomyelitis.

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Section: Discussionmentioning

confidence: 99%

One-Stage Hip Revision Arthroplasty Using Megaprosthesis in Severe Bone Loss of The Proximal Femur Due to Radiological Diffuse Osteomyelitis

2021

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“…Another interesting new approach is to administer specific markers that enrich within the tumor or the healthy surrounding tissue, as was described for the distinction of viable from nonviable bone in the case of septic revision of hip arthroplasty using tetracycline as a fluorescent marker [ 110 ]. What can also now readily be used is the generation of 3D models to plan the intended procedure [ 111 ].…”

Section: Current Trends and Future Perspectivesmentioning

confidence: 99%

Surgical Treatment of Bone Sarcoma

Bläsius

Delbrück

Hildebrand

et al. 2022

Cancers

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Bone sarcomas are rare primary malignant mesenchymal bone tumors. The three main entities are osteosarcoma, chondrosarcoma, and Ewing sarcoma. While prognosis has improved for affected patients over the past decades, bone sarcomas are still critical conditions that require an interdisciplinary diagnostic and therapeutic approach. While radiotherapy plays a role especially in Ewing sarcoma and chemotherapy in Ewing sarcoma and osteosarcoma, surgery remains the main pillar of treatment in all three entities. After complete tumor resection, the created bone defects need to be reconstructed. Possible strategies are implantation of allografts or autografts including vascularized bone grafts (e.g., of the fibula). Around the knee joint, rotationplasty can be performed or, as an alternative, the implantation of (expandable) megaprostheses can be performed. Challenges still associated with the implantation of foreign materials are aseptic loosening and infection. Future improvements may come with advances in 3D printing of individualized resection blades/implants, thus also securing safe tumor resection margins while at the same time shortening the required surgical time. Faster osseointegration and lower infection rates may possibly be achieved through more elaborate implant surface structures.

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Polychrome Bone Fluorescence: A Valuable Diagnostic Tool for Fourth-Degree Calvarial Burns. A Case Report

Malan,

Öhlbauer,

Bader

et al. 2024

Journal of Burn Care &Amp; Research

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4th degree calvarial burns are complex in management with regards to determining bone vitality and subsequent choice of defect coverage. Distinguishing viable and nonviable bone can be challenging. Tetracycline bone fluorescence is well described and in common use in maxillofacial patients with bisphosphonate osteonecrosis and has been reported in septic orthopedic surgery specifically periprosthetic joint infection. On the basis that viable bone fluoresces, the concept of polychrome fluorescence was extrapolated as a diagnostic tool for calvarial burns. Bone fluorescence presents an efficient, non-invasive, and cost-effective diagnostic tool delineating exact necrotic margins in 4th degree burns ensuring targeted bone sparing debridement. This report describes the use of polychrome bone fluorescence as an intra-operative tool including a single-centre case report with 4th degree calvarial burns.

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Fluorescent tetracycline bone labeling as an intraoperative tool to debride necrotic bone during septic hip revision: a preliminary case series

Cited by 5 publications

References 17 publications

One-Stage Hip Revision Arthroplasty Using Megaprosthesis in Severe Bone Loss of The Proximal Femur Due to Radiological Diffuse Osteomyelitis

One-Stage Hip Revision Arthroplasty Using Megaprosthesis in Severe Bone Loss of The Proximal Femur Due to Radiological Diffuse Osteomyelitis

Surgical Treatment of Bone Sarcoma

Polychrome Bone Fluorescence: A Valuable Diagnostic Tool for Fourth-Degree Calvarial Burns. A Case Report

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