SynthesisJournal of orthopaedic surgery and research2024
Single versus two-stage management of long-bone chronic osteomyelitis in adults: a systematic review and meta-analysis.
Synthesis in Journal of orthopaedic surgery and research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Harnessing gasotransmitters for orthopaedic infection therapy: Mechanisms and advanced delivery platforms.Bioactive materials · 2027Review
- Clinical, etiological, and microbiological differences between foot and non-foot osteomyelitis.Archives of orthopaedic and trauma surgery · 2026Article
- A promising therapeutic biomaterial: CHX@ZnO-HA/PSSS nanocomposites enable pH-Dependent infection eradication and bone regeneration in osteomyelitis.Journal of Taibah University Medical Sciences · 2026Article
- Osteomyelitis.Nature reviews. Disease primers · 2026Review
- Article
- Antibacterial polyphenols for osteomyelitis treatment: from antibacterial mechanisms to biomaterial-based delivery.Frontiers in cell and developmental biology · 2026Review
- Application of tranexamic acid during debridement for proximal-to-mid humeral chronic osteomyelitis: evaluation of blood management and infection-control safety.Frontiers in surgery · 2026Article
- Managing Nonunions and Fracture-Related Infections-A Quarter Century of Knowledge, and Still Curious: A Narrative Review.Journal of clinical medicine · 2025Review
- Review
- 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
- Single- versus two-stage revision surgery in the case of fracture-related infection: a systematic review.Journal of bone and joint infection · 2025Review
- Antimicrobial photodynamic therapy with 5-aminolevulinic acid plus antibiotics: a promising treatment for tibial osteomyelitis caused by drug-resistant bacteria.Frontiers in pharmacology · 2025Article
- Sequential release of vancomycin and BMP-2 from chitosan/nano-hydroxyapatite thermosensitive hydrogel for the treatment of chronic osteomyelitis.Journal of orthopaedic surgery and research · 2024Article
- Review
Corrections and comments
- Erratum issued
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronic osteomyelitis is a debilitating bone infection, characterized by a persistent infection over months to years, poses diagnostic and therapeutic challenges due to its insidious nature and potential for severe bone and soft tissue destruction. This systematic review and meta-analysis aims to review the literature on the treatment of chronic osteomyelitis in long bones and assess cure rates in single versus two-stage surgery.
methodsFollowing the PRISMA guidelines and registered with PROSPERO (ID: CRD42021231237), this review included studies that reported on the management of chronic osteomyelitis in long bones using either a planned one-stage or two-stage surgical approach in adult patients. Databases searched included Medline, Embase, Web of Science, CINAHL, HMIC, and AMED, using keywords related to osteomyelitis, long bones, and surgical management. Eligibility criteria focused on adults with chronic osteomyelitis in long bones, with outcomes reported after a minimum follow-up of 12 months. The meta-analysis utilized the random-effects model to pool cure rates.
resultsThe analysis included 42 studies with a total of 1605 patients. The overall pooled cure rate was 91% (CI 95%) with no significant difference observed between single-stage and two-stage surgeries (X2 = 0.76, P > 0.05). Complications were reported in 26.6% of cases in single-stage procedures and 27.6% in two-stage procedures, with prolonged wound drainage noted as a common issue. Dead space management techniques varied across studies, with antibiotic-loaded calcium sulphate beads used in 30.4% of cases.
conclusionThis meta-analysis reveals no significant difference in cure rates between single and two-stage surgical treatments for chronic osteomyelitis in long bones, supporting the efficacy of both approaches. The current treatment strategy should include a combination of debridement, dead space management using local and systematic antibiotics and soft tissue reconstruction if necessary.
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