S53p4 Bioactive Glass Putty in the Local Treatment of Cavitary Chronic Osteomyelitis

Abstract

Objective: Evaluating the clinical results of bioactive glass S53P4 putty for the treatment of cavitary chronic osteomyelitis. Methods: Retrospective observational study, including patients of any age with clinical and radiological diagnosis of chronic osteomyelitis, who underwent surgical debridement and implantation of bioactive glass S53P4 putty (BonAlive® Putty, Turku, Finland). Patients who underwent any plastic surgery on the soft tissues of the affected site or had segmental bone lesions or septic arthritis were excluded. Statistical analysis was performed using Excel®. Demographic data, as well as data on the lesion, treatment, and follow-up, were collected. Outcomes were classified as “disease-free survival,” “failure,” or “indefinite.” Results: This study included 31 patients, of which 71% were men and had with a mean age of 53.6 years (SD ± 24.2). In total, 84% were followed-up for at least 12 months and 67.7% had comorbidities. We prescribed combination antibiotic therapy for 64.5% of patients. In 47.1%, Staphylococcus aureus was isolated. Finally, we classified 90.3% of cases as “disease-free survival” and 9.7% as “indefinite.” Conclusion: Bioactive glass S53P4 putty is safe and effective to treat cavitary chronic osteomyelitis, including infections by resistant pathogens, such as methicillin-resistant S. aureus. Level of Evidence IV, Case Series.

Initial therapeutic evidence of a borosilicate bioactive glass (BSG) and Fe3O4 magnetic nanoparticle scaffold on implant-associated Staphylococcal aureus bone infection

“…The alkaline microenvironment not only fosters osteogenesis by modulating immune regulation [ 51 ], but also impedes bacterial energy metabolism and kills bacteria ultimately [ 52 ]. Some studies have demonstrated that bioactive glass, such as S53P4, are safe and effective in treating of osteomyelitis and can control infections caused by multidrug-resistant S. aureus strains [ 53 ]. Upon implantation into patient's infectious bone defects, the bioactive glass product has demonstrated a high infection cure rate ranging from 70.3 % to 90 %, underscoring the reliable therapeutic effects of BSG in bone infection treatment [ [54] , [55] , [56] , [57] ].…”

Outcome and Predictors of Treatment Failure in Chronic Osteomyelitis Using Bioactive Glass Granules and Putty Formulations

“…Interestingly, the bioglass-based putty showed a greater eradication of the infection when compared with the bioglass in granules. In addition, the putty presentation facilitates intraoperative handling, especially when filling the bone cavity, with less possibility of heterotopic calcification and fistulisation of the product [25].…”