Osteomyelitis: a review of current literature and concepts

Mast, Nicholas H.; Horwitz, Daniel S.

doi:10.1053/otor.2002.0000

Cited by 15 publications

(23 citation statements)

References 32 publications

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“…Serial CT images showed a radio-opaque area in the medial portion of the left femoral diaphysis. Obviously, new bone formation tends to enclose the infected area caused by osteomyelitis (Mast and Horwitz, 2002). As a serious health problem, osteomyelitis is defined as an infection of the bone and bone marrow resulting in inflammation, necrosis, and new bone formation, and is commonly observed from the pre-antibiotic era (Santos and Suby, 2015).…”

Section: Resultsmentioning

confidence: 99%

Assessing the physical and pathological traits of human skeletal remains from cemetery localities at the Rakhigarhi site of the Harappan Civilization

Woo

Waghmare

Kim

et al. 2018

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The Rakhigarhi site is the location of the ruins of an ancient megacity of the Harappan civilization and had not previously been investigated thoroughly. We tried to examine the physical and pathological traits of human skeletons (n = 37) from the cemetery at the site. In our study, a cranial index was calculated from one male skull (dolichocranic; index value = 65.78). The mean statures estimated by long bone length were 175.8 cm (male) and 166.1 cm (female). The indices of femoral diaphyseal shape were 79.8 (males) and 90.31 (females) for the platymeric index; and 113.78 (males) and 112.74 (female) for the pilasteric index. The dental health of the subjects appeared to be good as the overall prevalence of oral pathologies (caries and antemortem tooth loss) was generally low. Periosteal reactions were found in tibias and possible evidence of osteomyelitis was also observed in a femur. Some joint parts showed signs of osteoarthritis. Although various pathologies have been identified, we could not find any specific lesions suggestive of leprosy and tuberculosis in these skeletons. Although our study has added invaluable data to the existing information pool on the health and disease status of Harappan society, more accurate conjecture on the structure of Harrappan society based on bioarchaeological evidence will need additional research based on future excavations at Rakhigarhi cemetery.

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Section: Resultsmentioning

confidence: 99%

Assessing the physical and pathological traits of human skeletal remains from cemetery localities at the Rakhigarhi site of the Harappan Civilization

Woo

Waghmare

Kim

et al. 2018

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“…Usually, osteomyelitis treatment requires prolonged antibiotic therapy, with a course lasting a matter of weeks or months. Further, there is a need of high parenteral dose of antibiotic to achieve effective therapeutic drug concentrations in the infected bone [1]. Therefore, antibiotic-loaded bone cements have become a complementary treatment because of the resulting higher antibiotic concentration in the infected area [2, 5, 8, 20].…”

Section: Discussionmentioning

confidence: 99%

“…Osteomyelitis is defined as inflammation of bone and marrow cavity [1]. Osteomyelitis causes major morbidity and remains the most feared and difficult infection to treat in orthopedic surgery.…”

Section: Introductionmentioning

confidence: 99%

A New Type of Biphasic Calcium Phosphate Cement as a Gentamicin Carrier for Osteomyelitis

Chen

Lin

2013

Evidence-Based Complementary and Alternative Medicine

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Osteomyelitis therapy is a long-term and inconvenient procedure for a patient. Antibiotic-loaded bone cements are both a complementary and alternative treatment option to intravenous antibiotic therapy for the treatment of osteomyelitis. In the current study, the biphasic calcium phosphate cement (CPC), called α-TCP/HAP (α-tricalcium phosphate/hydroxyapatite) biphasic cement, was prepared as an antibiotics carrier for osteomyelitis. The developed biphasic cement with a microstructure of α-TCP surrounding the HAP has a fast setting time which will fulfill the clinical demand. The X-ray diffraction and Fourier transform infrared spectrometry analyses showed the final phase to be HAP, the basic bone mineral, after setting for a period of time. Scanning electron microscopy revealed a porous structure with particle sizes of a few micrometers. The addition of gentamicin in α-TCP/HAP would delay the transition of α-TCP but would not change the final-phase HAP. The gentamicin-loaded α-TCP/HAP supplies high doses of the antibiotic during the initial 24 hours when they are soaked in phosphate buffer solution (PBS). Thereafter, a slower drug release is produced, supplying minimum inhibitory concentration until the end of the experiment (30 days). Studies of growth inhibition of Staphylococcus aureus and Pseudomonas aeruginosa in culture indicated that gentamicin released after 30 days from α-TCP/HAP biphasic cement retained antibacterial activity.

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“…La maggior parte degli studi dimostra che 4-6 settimane di terapia antibiotica associata ad un accurato debridement e/o rimozione di mezzi di sintesi o protesi possa permettere l'eradicazione dell'infezione. Tuttavia la scelta della strategia terapeutica deve basarsi sull'attenta valutazione di ogni singolo paziente, sull'isolamento microbiologico e sulla presenza o meno di dispositivi ortopedici (10,17,22). Nel nostro studio i pazienti erano già stati sottoposti a differenti schemi terapeutici presso altri centri con rimozione, in due casi, dei mezzi di sintesi.…”

Section: Discussioneunclassified

Diagnostic and therapeutic aspects in patients with chronic osteomyelitis and prosthetic infections

Minichello¹,

Segala²,

Badia³

et al. 2008

Microbiol Med

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INTRODUZIONENonostante i progressi in campo profilattico e terapeutico, le infezioni osteo-articolari e protesiche rappresentano un problema grave e complesso per l'infettivologo ed il chirurgo ortopedico. Infatti, gli elevati tassi di successo della terapia antibiotica, che si osservano nella maggior parte delle malattie infettive, non sono stati ancora raggiunti nelle infezioni osteoarticolari, a causa delle caratteristiche anatomiche e fisiologiche dell'osso che richiedono trattamenti antibiotici protratti e spesso associati ad interventi chirurgici non sempre realizzabili o risolutivi. Inoltre, con l'incremento della popolazione anziana e dell'impiego sempre più esteso di impianti protesici ortopedici, l'incidenza di queste patologie è destinata ad aumentare. In Italia vengono ogni anno impiantate circa 50.000 protesi d'anca e 10.000 protesi di ginocchio. Mentre nel 1999 l'incidenza di infezione nelle protesi d'anca si attestava attorno a 1-1.5% all'anno, con l'aumento dei reimpianti, l'incidenza è allo stato attuale triplicata (3-5% all'anno). Si può pertanto stimare che in 100 pazienti operati si svilupperanno complessivamente 10-15 episodi infettivi importanti nell'arco di 10 anni (5). L'osteomielite cronica è caratterizzata da un'infezione persistente e recidivante che evolve in mesi o anni ed è caratterizzata, rispetto alla forma acuta, dalla presenza di un minor grado di infiammazione, sequestri, deposizione di tessuto osseo di neogenesi e tratti fistolosi. Gli schemi classificativi più utilizzati sono quelli di Waldvogel et al. e di Cierny et al. fondati, rispettivamente, sulla patogenesi e sull'anatomia dell'infezione e fisiologia dell'ospite (5,14,19). Se lo Stafilococco aureo rappresenta uno degli agenti etiologici maggiormente implicati nelle infezioni osteo-articolari, gli stafilococchi coagulasi-negativi, quali S. epidermidis, si riscontrano più frequentemente in quelle di protesi; streptococchi, anaerobi, enterococchi, batteri Gram-negativi e miceti si associano invece ad infezioni che coinvolgono principalmente l'immunocompromesso ed il trapiantato. In Italia, inoltre, come conseguenza dei flussi migratori dall'Africa e dall'Asia, si sta assistendo ad un incremento delle osteomieliti vertebrali sostenute da Mycobacterium tuberculosis (8, Aspetti diagnostici e terapeutici in pazienti con osteomieliti croniche ed infezioni protesiche SUMMARY Management of chronic osteomyelitis and prosthetic joint infections represents an emergent problem, despite the advances in antibiotics and new operative techniques. In order to evaluate the efficacy of a multidisciplinary approach we conducted a study on twelve patients with orthopedic devices related infections attending the Institute of Infectious Diseases of the University of Ferrara from 2001 to 2006, by analyzing clinical, laboratoristic and strumental outcomes.The best results were obtained for those patients who underwent surgical treatment, including bone debridement or removal of infected devices, associated with an adequate antibiotic treatment. M...

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Osteomyelitis: a review of current literature and concepts

Cited by 15 publications

References 32 publications

Assessing the physical and pathological traits of human skeletal remains from cemetery localities at the Rakhigarhi site of the Harappan Civilization

Assessing the physical and pathological traits of human skeletal remains from cemetery localities at the Rakhigarhi site of the Harappan Civilization

A New Type of Biphasic Calcium Phosphate Cement as a Gentamicin Carrier for Osteomyelitis

Diagnostic and therapeutic aspects in patients with chronic osteomyelitis and prosthetic infections

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