Clinical observation on the efficiency of primary implantation of vancomycin-loaded calcium phosphate cement in treatment of chronic osteomyelitis_West China Medical Journal

Authors：

 LANG Zhigang , YUAN Feng , LIANG Yuxiang , YU Shan

Department of Osteopathy, Sichuan Provincial Orthopedic Hospital, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LANG Zhigang, Email: 13438450717@163.com

Keywords：

Vancomycin; Calcium phosphate cement; Primary implantation; Chronic osteomyelitis

DOI：

10.7507/1002-0179.201701071

Video：

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Objective To explore the clinical efficiency of vancomycin-loaded calcium phosphate cement (CPC) in the treatment of chronic osteomyelitis (CO). Methods From December 1st 2014 to December 1st 2015, 98 patients with CO were randomly divided into the research group and the control group, with 49 in each group. The patients in the research group were primarily implanted with vancomycin-loaded CPC after debridement, while the ones in the control group were placed with irrigation and drainage device to take continous irrigation with antibiotics after debridement. The treatment effect and the recurrence rate in the two groups were observed. Results The patients in the two groups were followed up for 12 months. In the research group, 30 patients were cured, 16 were improved, and 3 were not improved with the total effective rate of 93.9%; no systemic adverse reactions and recurrence took place after the operation; X-ray results showed well CPC tamponade and partially degenerated osteogenesis. In the control group, 16 patients were cured, 20 were improved and 13 were not improved, with the total effective rate of 73.5%; 11 had recurrent inflammation in 2–6 months after operation and were reoperated again. Conclusion The primary implantation of vancomycin-loaded CPC in CO lesions can fill the dead space, resist infection persistently, induce osteogenesis in bone defect area, and reduce the recurrence of CO, which is an effective method for the treatment of CO.

Citation： LANG Zhigang, YUAN Feng, LIANG Yuxiang, YU Shan. Clinical observation on the efficiency of primary implantation of vancomycin-loaded calcium phosphate cement in treatment of chronic osteomyelitis. West China Medical Journal, 2017, 32(12): 1859-1862. doi: 10.7507/1002-0179.201701071 Copy

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9.	张展, 张春, 郭峭峰, 等. 载万古霉素硫酸钙在骨髓炎治疗中的应用. 中国医学科学院学报, 2013, 35(3): 337-342.
10.	丁志军, 唐勇, 李怡. 浅谈阳和汤加天仙子治疗慢性化脓性骨髓炎的临床运用. 时珍国医国药, 2008, 19(1): 200-201.
11.	张亮, 陈统一. 载药磷酸钙骨水泥研究进展. 国际骨科学杂志, 2012, 33(4):228-233.
12.	Chen K, Balloch R. Management of calcaneal osteomyelitis. Clin Podiatr Med Surg, 2010, 27(3): 417-429.
13.	何源龙, 郑欣, 陈一心. 抗感染材料应用于慢性骨髓炎治疗的研究进展. 中国矫形外科杂志, 2014, 22(5): 426-429.
14.	陈文昭, 黄山虎, 刘志礼. 万古霉素磷酸钙骨水泥治疗慢性骨髓炎疗效分析. 江西医药, 2013, 48(2): 127-128.
15.	毕军伟, 李盛华, 刘红喜, 等. PMMA 与 CPC 混合万古霉素治疗慢性骨髓炎疗效对比. 医学理论与实践, 2016, 29(6): 761-762.
16.	周健, 方涛林, 董健. 抗生素缓释载体在慢性骨髓炎治疗中的应用. 中华临床医师杂志: 电子版, 2011, 5(6): 1708-1711.
17.	张展, 张春, 张晓文, 等. 载万古霉素硫酸钙在人体内缓释药物的临床研究.中国医药导刊, 2015, 17(12): 1247-1250.
18.	张亮. 复合磷酸钙骨水泥改进性研究进展. 陕西医学杂志, 2010, 39(11): 1532-1534.

1. 褚立涛. 慢性骨髓炎治疗的研究进展. 医学研究生学报, 2013, 26(1): 90-92.
2. Arnold PG, Yugueros P, Hanssen AD. Muscle flaps in osteomyelitis of the lower extremity: a 20-year account. Plast Reconstr Surg, 1999, 104(1): 107-110.
3. 袁志, 胡蕴玉, 李明全, 等. 抗感染重组合异种骨对兔胫骨骨髓炎的治疗作用. 中华骨科杂志, 2003, 23(4): 230-234.
4. 杨文水. 骨髓炎. 北京: 科学技术出版社, 2000: 33-51.
5. 叶向阳, 甄平, 李晓飞, 等. 磷酸钙骨水泥药物缓释体系的研究应用. 中国组织工程研究与临床康复, 2009, 13(47): 9317-9320.
6. 叶增伟, 刘随意, 苏佳灿. 抗生素/磷酸钙骨水泥载药缓释系统研究进展. 创伤外科杂志, 2010, 12(5): 472-474, 封 3.
7. 陈红卫, 赵钢生, 王子阳, 等. 一期病灶清除载药磷酸钙人工骨充填治疗慢性骨髓炎. 临床骨科杂志, 2008, 11(6): 512-514.
8. 赵春成, 康彦忠, 陈长春. 载万古霉素磷酸钙治疗慢性跟骨骨髓炎疗效分析. 陕西医学杂志, 2014, 43(9): 1199-1200.
9. 张展, 张春, 郭峭峰, 等. 载万古霉素硫酸钙在骨髓炎治疗中的应用. 中国医学科学院学报, 2013, 35(3): 337-342.
10. 丁志军, 唐勇, 李怡. 浅谈阳和汤加天仙子治疗慢性化脓性骨髓炎的临床运用. 时珍国医国药, 2008, 19(1): 200-201.
11. 张亮, 陈统一. 载药磷酸钙骨水泥研究进展. 国际骨科学杂志, 2012, 33(4):228-233.
12. Chen K, Balloch R. Management of calcaneal osteomyelitis. Clin Podiatr Med Surg, 2010, 27(3): 417-429.
13. 何源龙, 郑欣, 陈一心. 抗感染材料应用于慢性骨髓炎治疗的研究进展. 中国矫形外科杂志, 2014, 22(5): 426-429.
14. 陈文昭, 黄山虎, 刘志礼. 万古霉素磷酸钙骨水泥治疗慢性骨髓炎疗效分析. 江西医药, 2013, 48(2): 127-128.
15. 毕军伟, 李盛华, 刘红喜, 等. PMMA 与 CPC 混合万古霉素治疗慢性骨髓炎疗效对比. 医学理论与实践, 2016, 29(6): 761-762.
16. 周健, 方涛林, 董健. 抗生素缓释载体在慢性骨髓炎治疗中的应用. 中华临床医师杂志: 电子版, 2011, 5(6): 1708-1711.
17. 张展, 张春, 张晓文, 等. 载万古霉素硫酸钙在人体内缓释药物的临床研究.中国医药导刊, 2015, 17(12): 1247-1250.
18. 张亮. 复合磷酸钙骨水泥改进性研究进展. 陕西医学杂志, 2010, 39(11): 1532-1534.

West China Medical Journal

Clinical observation on the efficiency of primary implantation of vancomycin-loaded calcium phosphate cement in treatment of chronic osteomyelitis

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