The Fate of Antibiotic Impregnated Cement Space in Treatment for Forefoot Osteomyelitis

Woo, Inha; Park, Jeong Jin; Seok, Hyun-Gyu; Park, Chul Hyun

doi:10.3390/jcm11071976

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…Yalikun et al showed that 88% of reinfections occurred at the docking site 47 . Second, the local antibiotics in the cement spacer can achieve a concentration far above the minimal inhibitory concentration to eradicate residual pathogens after debridement 37,48,49 . Additionally, the staged surgical process guaranteed a high cure rate, especially in patients with poor soft-tissue condition and active infections 37 .…”

Section: Discussionmentioning

confidence: 99%

Debridement-Reconstruction-Docking Management System Versus Ilizarov Technique for Lower-Extremity Osteomyelitis

Ren,

Cai,

et al. 2023

Journal of Bone and Joint Surgery

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Background: Osteomyelitis causes marked disability and is one of the most challenging diseases for orthopaedists to treat because of the considerable rate of infection recurrence. In this study, we proposed and assessed the debridement-reconstruction-docking (DRD) system for the treatment of lower-extremity osteomyelitis. This procedure comprises 3 surgical stages and 2 preoperative assessments; namely, pre-debridement assessment, debridement, pre-reconstruction assessment, reconstruction, and docking-site management. We evaluated the use of the DRD system compared with the Ilizarov technique, which is defined as a 1-stage debridement, osteotomy, and bone transport. Methods: This retrospective cohort included 289 patients who underwent either DRD or the Ilizarov technique for the treatment of lower-extremity osteomyelitis at a single institution between January 2013 and February 2021 and who met the eligibility criteria. The primary outcome was the rate of infection recurrence. Secondary outcomes included the external fixator index (EFI), refracture rate, and the Paley classification for osseous and functional results. An inverse-probability-weighted regression adjustment model was utilized to estimate the effect of the DRD system and Ilizarov technique on the treatment of lower-extremity osteomyelitis. Results: A total of 131 and 158 patients underwent DRD or the Ilizarov technique, respectively. The inverse-probability-weighted regression adjustment model suggested that DRD was associated with a significant reduction in infection recurrence (risk ratio [RR], 0.26; 95% confidence interval [CI], 0.13 to 0.50; p < 0.001) and EFI (−6.9 days/cm, 95% CI; −8.3 to −5.5; p < 0.001). Patients in the DRD group had better Paley functional results than those in the Ilizarov group (ridit score, 0.55 versus 0.45; p < 0.001). There was no significant difference between the 2 groups in the rate of refracture (RR, 0.87; 95% CI, 0.42 to 1.79; p = 0.71) and Paley osseous results (ridit score, 0.51 versus 0.49; p = 0.39). Conclusions: In this balanced retrospective cohort of patients with lower-extremity osteomyelitis, the use of the DRD system was associated with a reduced rate of infection recurrence, a lower EFI, and better Paley functional results compared with the use of the Ilizarov technique. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Debridement-Reconstruction-Docking Management System Versus Ilizarov Technique for Lower-Extremity Osteomyelitis

Ren,

Cai,

et al. 2023

Journal of Bone and Joint Surgery

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“…In the published publication [ 1 ], there were not added the affiliations for new added authors Tae-gon Kim, Jun Sung Moon and Seung Min Chung. The newly added affiliations appear here.…”

Section: Additional Affiliationsmentioning

confidence: 99%

Correction: Woo et al. The Fate of Antibiotic Impregnated Cement Space in Treatment for Forefoot Osteomyelitis. J. Clin. Med. 2022, 11, 1976

Woo

Park

Seok

et al. 2022

JCM

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“…Diabetes mellitus (DM) is a devastating disease that affects multiple organs, including the heart, kidneys, and nerves [ 1 , 2 ]. Diabetic foot is a common complication in approximately 6.3% of patients with DM [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

State-of-the-art update for diagnosing diabetic foot osteomyelitis: a narrative review

Woo,

Cho,

Park

2023

JYMS

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Recently, the International Working Group on the Diabetic Foot and the Infectious Diseases Society of America divided diabetic foot disease into diabetic foot infection (DFI) and diabetic foot osteomyelitis (DFO). DFI is usually diagnosed clinically, while numerous methods exist to diagnose DFO. In this narrative review, the authors aim to summarize the updated data on the diagnosis of DFO. An extensive literature search using “diabetic foot [MeSH]” and “osteomyelitis [MeSH]” or “diagnosis” was performed using PubMed and Google Scholar in July 2023. The possibility of DFO is based on inflammatory clinical signs, including the probe-to-bone (PTB) test. Elevated inflammatory biochemical markers, especially erythrocyte sedimentation rate, are beneficial. Distinguishing abnormal findings of plain radiographs is also a first-line approach. Moreover, sophisticated modalities, including magnetic resonance imaging and nuclear medicine imaging, are helpful if doubt remains after a first-line diagnosis. Transcutaneous bone biopsy, which does not pass through the wound, is necessary to avoid contaminating the sample. This review focuses on the current diagnostic techniques for DFOs with an emphasis on the updates. To obtain the correct therapeutic results, selecting a proper option is necessary. Based on these numerous diagnosis modalities and indications, the proper choice of diagnostic tool can have favorable treatment outcomes.

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The Fate of Antibiotic Impregnated Cement Space in Treatment for Forefoot Osteomyelitis

Cited by 5 publications

References 24 publications

Debridement-Reconstruction-Docking Management System Versus Ilizarov Technique for Lower-Extremity Osteomyelitis

Debridement-Reconstruction-Docking Management System Versus Ilizarov Technique for Lower-Extremity Osteomyelitis

Correction: Woo et al. The Fate of Antibiotic Impregnated Cement Space in Treatment for Forefoot Osteomyelitis. J. Clin. Med. 2022, 11, 1976

State-of-the-art update for diagnosing diabetic foot osteomyelitis: a narrative review

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