ArticleAntibiotics (Basel, Switzerland)2024
Revisiting Antibiotic-Impregnated Cement Spacer for Diabetic Osteomyelitis of the Foot.
Article in Antibiotics (Basel, Switzerland), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- [Expert consensus on the application of bone cement in the treatment of diabetic wounds (2026 edition)].Zhonghua shao shang yu chuang mian xiu fu za zhi · 2026Article
- Management of Chronic Septic Arthritis and Osteomyelitis Following Hallux Valgus Correction With Staged Antibiotic Cement Spacer and Subsequent Bulk Allograft Arthrodesis.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026Article
- Staged antibiotic-loaded cement-based reconstruction versus flap-based reconstruction for complex diabetic foot defects in patients with osteoporosis: a retrospective cohort study.Frontiers in surgery · 2026Article
- Novel Treatments for Diabetic Foot Osteomyelitis: A Narrative Review.Microorganisms · 2025Review
- Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDespite the rising global awareness and improvement of socioeconomic and living standards, the prevalence of diabetic osteomyelitis (DOM) and its complications has been increasing rapidly. This study aims to investigate the long-term prognosis of DOM of the foot treated using antibiotic-impregnated cement spacer (ACS) and the contributing risk factors for reoperation. METHODS AND MATERIALS: We retrospectively reviewed the data of 55 diabetic patients with Meggitt-Wagner Grade IIB wounds diagnosed with osteomyelitis of the foot, treated in our institution with excessive debridement, excision of the infected tissue, and implantation of antibiotic-impregnated cement spacer fixed with a Kirschner wire. Descriptive statistics, including patient demographics, were analyzed. Statistical analysis was performed using point-biserial correlation and a Chi-square test with Cramer's V effect-size estimation to determine the relationship between reoperation and various parameters.
results55 patients (36 (65.45%) males and 19 (34.55%) females) with a median age of 64 (39-84) years were thoroughly analyzed throughout a median follow-up of 884 days (2-4671 days). Of the entire cohort, 29 (52.72%) patients achieved primary successful infection eradication without any further intervention, and 8 (14.54%) patients were successfully treated using a secondary procedure. More than half of the reoperated patients underwent the secondary intervention within less than a month after the primary ACS. When assessing correlation, age (r = 0.28,
conclusionsACS has shown excellent results in eradicating bone infection with up to 7.23 years of follow-up, acting as a structural stabilizer, preventing soft tissue contractures, and delivering highly concentrated local antibiotic treatment both to soft tissue and bone. Regardless, specific factors should be thoroughly evaluated prior to surgery, as advancing age, gender, and the use of gentamicin-only antibiotics appear to be positively associated with a higher likelihood of reoperation. Conversely, infections caused by cultured
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