ArticleThe bone & joint journal2022
Mid- to long-term results of single-stage surgery for patients with chronic osteomyelitis using a bioabsorbable gentamicin-loaded ceramic carrier.
Article in The bone & joint journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.
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Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 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
- Successful glenoid defect management with antibiotic-eluting bone graft substitute following baseplate removal in two-stage revision reverse shoulder arthroplasty: a case report and surgical considerations.JSES reviews, reports, and techniques · 2026Article
- Reported practice patterns in the use of local antibiotics for fracture-related infection among SICOT respondents: an international survey.BMC musculoskeletal disorders · 2026Article
- Short or Long Antibiotic Regimens in Orthopedics.The New England journal of medicine · 2026Article
- MRSA-dominant colonization and synergistic pathogenicity withJournal of orthopaedic translation · 2026Article
- Impact of Narrow Empiric Antibiotic Spectrum and Patient Characteristics on Clinical Outcomes in Bone and Joint Infections: A Retrospective Cohort Study.Antibiotics (Basel, Switzerland) · 2026Article
- Threaded Antibiotic-Coated Locking Nails in Osteomyelitis-Associated Long-Bone Non-Union: Short-Term Outcomes of a Prospective Cohort.Healthcare (Basel, Switzerland) · 2026Article
- Local Antibiotic-Loadable Carriers for the Treatment of Chronic Osteomyelitis: A Narrative Review.Bioengineering (Basel, Switzerland) · 2026Review
- Intramedullary nailing with an absorbable antibiotic bone graft substitute in fracture-related infections and osteomyelitis: a case series.OTA international : the open access journal of orthopaedic trauma · 2026Article
- Sculpting the Future of Bone: The Evolution of Absorbable Materials in Orthopedics.Advanced materials (Deerfield Beach, Fla.) · 2026Review
- Gentamicin fails to eradicateJournal of bone and joint infection · 2026Article
- Chronic osteomyelitis diagnosis using MRI: optimising radiomics models through multi-level region of interest extensions.Frontiers in bioengineering and biotechnology · 2026Article
- Staged Management of Bone Defects in Chronic Osteomyelitis and Nonunions Using Antibiotic-Loaded Calcium Sulphate-Hydroxyapatite: A Multicenter Retrospective Analysis of 101 Cases.Therapeutics and clinical risk management · 2026Article
- Exploring the Value of Paired Microbiology and Histology in Chronic Osteomyelitis and Fracture-Related Infections.Antibiotics (Basel, Switzerland) · 2025Article
- Medial Femoral Condyle Flap as Salvage for Osteomyelitic Clavicle Nonunion.Plastic and reconstructive surgery. Global open · 2025Article
- Managing Nonunions and Fracture-Related Infections-A Quarter Century of Knowledge, and Still Curious: A Narrative Review.Journal of clinical medicine · 2025Review
- A Scoping Review of CERAMENT™ Applications in Orthopedic Surgery.Journal of clinical medicine · 2025Review
- Current Concepts of Local Antibiotic Delivery in Bone and Joint Infections-A Narrative Review of Techniques and Clinical Experiences.Microorganisms · 2025Review
- Cementless one-stage hip revision arthroplasty with an injectable antibiotic bone graft substitute : a pilot study.Bone & joint open · 2025Article
- Clinically applicable antibiotic modification of ready-to-use calcium phosphate cement pastes.Journal of orthopaedic surgery and research · 2025Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsExcision of chronic osteomyelitic bone creates a dead space which must be managed to avoid early recurrence of infection. Systemic antibiotics cannot penetrate this space in high concentrations, so local treatment has become an attractive adjunct to surgery. The aim of this study was to present the mid- to long-term results of local treatment with gentamicin in a bioabsorbable ceramic carrier.
methodsA prospective series of 100 patients with Cierny-Mader Types III and IV chronic ostemyelitis, affecting 105 bones, were treated with a single-stage procedure including debridement, deep tissue sampling, local and systemic antibiotics, stabilization, and immediate skin closure. Chronic osteomyelitis was confirmed using strict diagnostic criteria. The mean follow-up was 6.05 years (4.2 to 8.4).
resultsAt final follow-up, six patients (six bones) had recurrent infection; thus 94% were infection-free. Three infections recurred in the first year, two in the second year, and one 4.5 years postoperatively. Recurrence was not significantly related to the physiological class of the patient (1/20 Class A (5%) vs 5/80 Class B (6.25%); p = 0.833), nor was it significantly related to the aetiology of the infection, the organisms which were cultured or the presence of nonunion before surgery (1/10 with nonunion (10%) vs 5/90 without nonunion (5.6%); p = 0.570). Organisms with intermediate or high-grade resistance to gentamicin were significantly more likely in polymicrobial infections (9/21; 42.8%) compared with monobacterial osteomyelitis (7/79 (8.9%); p < 0.001). However, recurrence was not significantly more frequent when a resistant organism was present (1/16 for resistant cases (6.25%) vs 5/84 in those with a microbiologically sensitive infection (5.95%); p = 0.958).
conclusionWe found that a single-stage protocol, including the use of a high-delivery local antibiotic ceramic carrier, was effective over a period of several years. The method can be used in a wide range of patients, including those with significant comorbidities and an infected nonunion.Cite this article:
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