The Use of Calcium Sulphate Beads in the Management of Osteomyelitis of Femur and Tibia: A Systematic Review.
Antibiotic beads
Bone infection
Calcium sulphate beads
Long-bone osteomyelitis
Stimulan
Journal
The archives of bone and joint surgery
ISSN: 2345-4644
Titre abrégé: Arch Bone Jt Surg
Pays: Iran
ID NLM: 101636743
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
26
11
2020
accepted:
24
07
2021
entrez:
20
6
2022
pubmed:
21
6
2022
medline:
21
6
2022
Statut:
ppublish
Résumé
Calcium sulphate is a recent alternative for delayed antibiotic elution in infected bones and joints. The purpose of this study is to evaluate the use of antibiotic impregnated calcium sulphate (AICS) beads in the management of infected tibia and femur, with regards to patient outcomes and complication rates (including reinfection rate, remission rate and union rate). Searches of AMED, CINAHL, EMBASE, EMCARE, Medline, PubMed and Google Scholar were conducted in June 2020, with the mesh terms: "Calcium sulphate beads" or "Calcium sulfate beads" or "antibiotic beads" or "Stimulan" AND "Bone infection" or "Osteomyelitis" or "Debridement" AND "Tibia" or "Femur". Risk of bias was assessed using the Risk of Bias in Non-randomised Studies of interventions (ROBINS-i) tool, and quality assessed via the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria. Out of 104 relevant papers, 10 met the inclusion criteria for data extraction. Total infection remission was 6.8%, which was greater than that of polymethylmethacrylate (PMMA, 21.2%). Complication rates varied. The main issue regarding AICS use was wound drainage, which was considerably higher in studies involving treatment of tibia alone. Studies using PMMA did not experience this issue, but there were a few incidences of superficial pin tract infection following surgery. Where AICS was used, it was consistently effective at infection eradication, despite variation in causative organism and location of bead placement. Wound drainage varied and was higher in papers regarding tibial cases alone.
Sections du résumé
Background
UNASSIGNED
Calcium sulphate is a recent alternative for delayed antibiotic elution in infected bones and joints. The purpose of this study is to evaluate the use of antibiotic impregnated calcium sulphate (AICS) beads in the management of infected tibia and femur, with regards to patient outcomes and complication rates (including reinfection rate, remission rate and union rate).
Methods
UNASSIGNED
Searches of AMED, CINAHL, EMBASE, EMCARE, Medline, PubMed and Google Scholar were conducted in June 2020, with the mesh terms: "Calcium sulphate beads" or "Calcium sulfate beads" or "antibiotic beads" or "Stimulan" AND "Bone infection" or "Osteomyelitis" or "Debridement" AND "Tibia" or "Femur". Risk of bias was assessed using the Risk of Bias in Non-randomised Studies of interventions (ROBINS-i) tool, and quality assessed via the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria.
Results
UNASSIGNED
Out of 104 relevant papers, 10 met the inclusion criteria for data extraction. Total infection remission was 6.8%, which was greater than that of polymethylmethacrylate (PMMA, 21.2%). Complication rates varied. The main issue regarding AICS use was wound drainage, which was considerably higher in studies involving treatment of tibia alone. Studies using PMMA did not experience this issue, but there were a few incidences of superficial pin tract infection following surgery.
Conclusion
UNASSIGNED
Where AICS was used, it was consistently effective at infection eradication, despite variation in causative organism and location of bead placement. Wound drainage varied and was higher in papers regarding tibial cases alone.
Identifiants
pubmed: 35721593
doi: 10.22038/ABJS.2021.53566.2661
pmc: PMC9169733
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
320-327Déclaration de conflit d'intérêts
The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper
Références
Clin Orthop Relat Res. 2003 Sep;(414):7-24
pubmed: 12966271
J Orthop Surg Res. 2019 Nov 28;14(1):393
pubmed: 31779664
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
Bone Joint J. 2016 Sep;98-B(9):1289-96
pubmed: 27587534
J Bone Joint Surg Am. 1946 Apr;28:343-50
pubmed: 21020238
Br Med J. 1942 May 16;1(4245):616-7
pubmed: 20784237
Acta Orthop Scand. 1998 Oct;69(5):518-22
pubmed: 9855236
Bone Joint Res. 2018 Nov 03;7(10):570-579
pubmed: 30464837
Strategies Trauma Limb Reconstr. 2014 Nov;9(3):157-61
pubmed: 25540119
J Clin Epidemiol. 2009 Oct;62(10):e1-34
pubmed: 19631507
J Mater Sci Mater Med. 2005 Sep;16(9):843-50
pubmed: 16167113
Mil Med. 2004 Sep;169(9):728-34
pubmed: 15495730
Bone Joint J. 2017 Nov;99-B(11):1537-1544
pubmed: 29092996
J Orthop Surg Res. 2020 Jun 1;15(1):201
pubmed: 32487197
J Bone Jt Infect. 2017 Oct 9;2(4):194-201
pubmed: 29119078
Clin Orthop Relat Res. 2006 Oct;451:4-9
pubmed: 17038921
J Orthop. 2018 May 07;15(2):676-678
pubmed: 29881219
Bone Joint J. 2015 Sep;97-B(9):1237-41
pubmed: 26330591
Arch Surg. 1988 Nov;123(11):1320-7
pubmed: 3178479
J Trauma. 2008 Dec;65(6):1416-20
pubmed: 19077636
Lancet. 2004 Jul 24-30;364(9431):369-79
pubmed: 15276398
J Trauma. 1998 Oct;45(4):758-64
pubmed: 9783617
Bone Joint J. 2014 Jun;96-B(6):829-36
pubmed: 24891586
Arch Surg (1920). 1945 Sep;51:81-92
pubmed: 21005215
J Bone Jt Infect. 2020 Feb 10;5(1):43-49
pubmed: 32117689
J Bone Jt Infect. 2018 May 15;3(2):87-93
pubmed: 29922571
BMC Musculoskelet Disord. 2017 Jun 12;18(1):256
pubmed: 28606128
Pak J Pharm Sci. 2018 Nov;31(6(Special)):2783-2786
pubmed: 30630784