Through the looking glass; bioactive glass S53P4 (BonAlive®) in the treatment of chronic osteomyelitis

McAndrew, Joseph; Efrimescu, Catalin-Iulian; Sheehan, Eoin; Niall, D.

doi:10.1007/s11845-012-0895-5

Cited by 55 publications

(43 citation statements)

References 7 publications

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“…We are unaware of any reported bacterial resistance to this compound. Our results on a larger population confirm the observations of previous studies, 18,26 showing approximately a 90% eradication rate at a mean of 21.8 months' follow-up (12 to 36), irrespective of the isolated pathogen and the host type.…”

Section: Discussionsupporting

confidence: 91%

“…18,26 Given the recent approval of BAG S53P4 (BonAlive, BonAlive Biomaterials Ltd, Biolinja, Finland) as a medical device in Europe for the treatment of osteomyelitis, we undertook a study to evaluate its efficacy and safety in a large continuous series of patients treated for chronic osteomyelitis involving the long bones. This was a retrospective, non-randomised comparative study between a consecutive series of patients treated with two different calcium-based antibiotic-loaded bone substitutes or with bioactive glass S53P4.…”

mentioning

confidence: 99%

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A comparative study of the use of bioactive glass S53P4 and antibiotic-loaded calcium-based bone substitutes in the treatment of chronic osteomyelitis

Romanò

Logoluso

Meani

et al. 2014

The Bone & Joint Journal

127

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The treatment of chronic osteomyelitis often includes surgical debridement and filling the resultant void with antibiotic-loaded polymethylmethacrylate cement, bone grafts or bone substitutes. Recently, the use of bioactive glass to treat bone defects in infections has been reported in a limited series of patients. However, no direct comparison between this biomaterial and antibiotic-loaded bone substitute has been performed. In this retrospective study, we compared the safety and efficacy of surgical debridement and local application of the bioactive glass S53P4 in a series of 27 patients affected by chronic osteomyelitis of the long bones (Group A) with two other series, treated respectively with an antibiotic-loaded hydroxyapatite and calcium sulphate compound (Group B; n = 27) or a mixture of tricalcium phosphate and an antibiotic-loaded demineralised bone matrix (Group C; n = 22). Systemic antibiotics were also used in all groups. After comparable periods of follow-up, the control of infection was similar in the three groups. In particular, 25 out of 27 (92.6%) patients of Group A, 24 out of 27 (88.9%) in Group B and 19 out of 22 (86.3%) in Group C showed no infection recurrence at means of 21.8 (12 to 36), 22.1 (12 to 36) and 21.5 (12 to 36) months follow-up, respectively, while Group A showed a reduced wound complication rate. Our results show that patients treated with a bioactive glass without local antibiotics achieved similar eradication of infection and less drainage than those treated with two different antibiotic-loaded calcium-based bone substitutes.

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

A comparative study of the use of bioactive glass S53P4 and antibiotic-loaded calcium-based bone substitutes in the treatment of chronic osteomyelitis

Romanò

Logoluso

Meani

et al. 2014

The Bone & Joint Journal

127

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“…Despite the in vitro evidence of antibacterial efficacy of BAG-S53P4, a relatively limited number of clinical studies have explored the potential use of these materials for the treatment of chronic osteomyelitis. To our best knowledge, only two studies, on limited patients’ populations have been published so far concerning a possible application for the treatment of osteomyelitis of the long bones [14,19]. Our results confirm, on a larger population, previous studies, showing an approximately 90% eradication rate at an average 18 months follow-up, independently on the isolated pathogen.…”

Section: Discussionsupporting

confidence: 87%

“…In particular, antibacterial properties have been put in correlation with a local pH and osmotic pressure increase, since sodium and calcium ions and phosphorus salts make the environment hostile for bacterial adhesion and the subsequent proliferation of microorganisms that cause infection [15,16]. Despite the increasing amount of in vitro evidence concerning BAGs antibacterial properties, and the long term clinical use in treating chronically infected bone in cranio-maxillofacial indications [17,18], only two clinical studies, on a limited series of patients, have explored the potential use of BAGs for the treatment of chronic osteomyelitis so far in an orthopaedic setting [14,19]. …”

Section: Introductionmentioning

confidence: 99%

Bioactive glass BAG-S53P4 for the adjunctive treatment of chronic osteomyelitis of the long bones: an in vitroand prospective clinical study

Drago

Romanò²,

Vecchi

et al. 2013

BMC Infect Dis

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BackgroundThis study aimed to explore the in vitro antibacterial activity of the bioglass BAG S53P4 against multi-resistant microorganisms commonly involved in osteomyelitis and to evaluate its use in surgical adjunctive treatment of osteomyelitis.MethodsIn vitro antibacterial activity of BAG-S53P4 against methicillin resistant Staphylococcus aureus and Staphylococcus epidermidis, Pseudomonas aeruginosa and Acinetobacter baumannii isolates was evaluated by means of time kill curves, with colony counts performed after 24, 48 and 72 hours of incubation. In vivo evaluation was performed by prospectively studying a cohort of 27 patients with a clinically and radiologically diagnosed osteomyelitis of the long bones in an observational study. Endpoints were the absence of infection recurrence/persistence at follow-up, no need for further surgery whenever during follow-up and absence of local or systemic side effects connected with the BAG use.ResultsIn vitro tests regarding the antibacterial activity of BAG S53P4 showed a marked bactericidal activity after 24 hrs against all the tested species. This activity continued in the subsequent 24 hrs and no growth was observed for all strains after 72 hrs. Results of the clinical study evidenced no signs of infection in 24 patients (88.9%) at the follow-up, while 2 subjects showed infection recurrence at 6 months from index operation and one more needed further surgical procedures. BAG-S53P4 was generally well tolerated.ConclusionsThe in vitro and in vivo findings reinforce previous observations on the efficacy of BAG-S53P4 for the treatment of chronic osteomyelitis of the long bones, also in the presence of multi-resistant strains and in immunocompromised hosts, without relevant side effects and without the need for locally adding antibiotics.Trial registrationDeutschen Register Klinischer Studien (DRKS) unique identifier: DRKS00005332.

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“…BAG‐S53P4 does not favor adhesion or colonization of several pathogens on its surface . Also, promising results were obtained in dead space management in chronic osteomyelitis . The ability of BAG‐S53P4 to inhibit bacterial growth is based on simultaneous processes that occur when the bioactive glass reacts with body fluids.…”

mentioning

confidence: 99%

Efficacy of antibacterial bioactive glass S53P4 against S. aureus biofilms grown on titanium discs in vitro

Coraça‐Huber

Fille

Hausdorfer

et al. 2013

Journal Orthopaedic Research

101

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We evaluated the effectiveness of different sizes of bioactive glass S53P4 against Staphylococcus aureus biofilms grown on metal discs in vitro. S. aureus biofilms were cultivated on titanium discs. BAG-S53P4 (0.5-0.8 mm and <45 µm) were placed in contact with the discs containing biofilms. Glass beads (0.5 mm) were used as a control. After each interval, the pH from each sample was measured. Colony forming units were counted for the biofilm recovery verification. In parallel, we tested the activity of bioactive glass against S. aureus planktonic cells. We found that BAG-S53P4 can suppress S. aureus biofilm formation on titanium discs in vitro. The suppression rate of biofilm cells by BAG-S53P4 <45 µm was significantly higher than by BAG-S53P4 0.5-0.8 mm. BAG-S53P4 has a clear growth-inhibitory effect on S. aureus biofilms. BAG-S53P4 <45 µm is more efficient against biofilm growth in vitro comparing with BAG-S53P4 0.5-0.8 mm. Bioactive glass S53P4 has potential to be used as bone substitute for the resolution of infection complications in joint replacement surgeries and treatment of chronic osteomyelitis.

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Through the looking glass; bioactive glass S53P4 (BonAlive®) in the treatment of chronic osteomyelitis

Abstract: Though a relatively recent development, bioactive glass used in concurrence with antibiotic therapy has significant potential in the treatment of chronic osteomyelitis.

Cited by 55 publications

References 7 publications

A comparative study of the use of bioactive glass S53P4 and antibiotic-loaded calcium-based bone substitutes in the treatment of chronic osteomyelitis

A comparative study of the use of bioactive glass S53P4 and antibiotic-loaded calcium-based bone substitutes in the treatment of chronic osteomyelitis

Bioactive glass BAG-S53P4 for the adjunctive treatment of chronic osteomyelitis of the long bones: an in vitroand prospective clinical study

Efficacy of antibacterial bioactive glass S53P4 against S. aureus biofilms grown on titanium discs in vitro

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