ArticleBMC musculoskeletal disorders2022
Treatment of chronic osteomyelitis with antibiotic-impregnated polymethyl methacrylate (PMMA) - the Cierny approach: is the second stage necessary?
Article in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Single versus two-stage management of long-bone chronic osteomyelitis in adults: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2024Pooled it
- A retrospective cohort study comparing the effects on inflammatory response and clinical outcomes of vancomycin-PMMA versus vancomycin-sulfate calcium in chronic osteomyelitis.Annals of medicine · 2026Article
- Antimicrobial efficiency of pH-responsive PAA/PAH-coated and flucloxacillin loaded titanium implants in the Galleria mellonella model.Drug delivery and translational research · 2026Article
- Engineering Smart Scaffolds for Osteomyelitis: Integrating Nanotechnology, Drug Delivery, and Tissue Regeneration-A Narrative Review.Journal of functional biomaterials · 2026Review
- Article
- Subacute Bifocal Salmonella Osteomyelitis of the Mid Shaft of Femur and Ipsilateral Proximal Tibia in a Healthy Female: A Case Report.Journal of orthopaedic case reports · 2025Article
- The Use of the Masquelet Technique in the Treatment of Pathological Distal Third Femoral Fracture Secondary to Chronic Osteomyelitis.Life (Basel, Switzerland) · 2025Article
- Article
- Article
- Antibiotic artificial bone implantation for the treatment of infection after internal fixation of tibial plateau fractures.BMC musculoskeletal disorders · 2022Article
- Clinical Applications of Poly-Methyl-Methacrylate in Neurosurgery: The In Vivo Cranial Bone Reconstruction.Journal of functional biomaterials · 2022Article
- Use of Fluconazole-impregnated Beads to Treat Osteomyelitis Caused byComparative medicine · 2022Article
- PMMA-cement anterior column reconstruction in surgical treatment of spondylodiscitis.Brain & spine · 2022Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronic osteomyelitis is a challenge for orthopedic surgeons. Most patients with osteomyelitis receive two-stage management according to Cierny-Mader. The first stage includes radical debridement and insertion of an antibiotic-impregnated cement spacer (ACS) (beads, rods, nails, or blocks) into the bone defect. The second stage is performed 6-8 weeks later, when the spacer is removed and a cancellous autograft is placed within the bone defect. The possibility of ACS as definitive management for osteomyelitis, avoiding the second stage, is presented.
methodsSixteen patients with osteomyelitis received radical debridement and insertion of an ACS in all forms into the bone defect as a definitive management. In 8 patients, the tibia was infected, 4 had femur infection, 2 humerus, 1 fibula, and 1 ankle. The mean age at the time of the first stage of reconstruction was 49 years (range, 13-71 years). According to the Cierny-Mader classification, 1 patient was C-M IA, another was IB, 7 IIIA, 6 IIIB, and 1 was 4A. All B hosts had systemic illnesses. The mean follow-up period was 6 years (1.5-16 years).
resultsNo patient exhibited radiographic evidence of excessive bone loss. Signs of recurrence of osteomyelitis were not noted in any of the patients, and no fractures had occurred by the last follow-up.
conclusionOur study suggests that a proportion of patients with planned retention of ACS appear to function well without requiring further surgical intervention, especially in elderly or vulnerable patients.
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