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：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

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

1.	褚立濤. 慢性骨髓炎治療的研究進展. 醫學研究生學報, 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, 胡蘊玉, 李明全, 等. 抗感染重組合異種骨對兔脛骨骨髓炎的治療作用. 中華骨科雜志, 2003, 23(4): 230-234.
4.	楊文水. 骨髓炎. 北京: 科學技術出版社, 2000: 33-51.
5.	葉向陽, 甄平, 李曉飛, 等. 磷酸鈣骨水泥藥物緩釋體系的研究應用. 中國組織工程研究與臨床康復, 2009, 13(47): 9317-9320.
6.	葉增偉, 劉隨意, 蘇佳燦. 抗生素/磷酸鈣骨水泥載藥緩釋系統研究進展. 創傷外科雜志, 2010, 12(5): 472-474, 封 3.
7.	陳紅衛, 趙鋼生, 王子陽, 等. 一期病灶清除載藥磷酸鈣人工骨充填治療慢性骨髓炎. 臨床骨科雜志, 2008, 11(6): 512-514.
8.	趙春成, 康彥忠, 陳長春. 載萬古霉素磷酸鈣治療慢性跟骨骨髓炎療效分析. 陜西醫學雜志, 2014, 43(9): 1199-1200.
9.	張展, 張春, 郭峭峰, 等. 載萬古霉素硫酸鈣在骨髓炎治療中的應用. 中國醫學科學院學報, 2013, 35(3): 337-342.
10.	丁志軍, 唐勇, 李怡. 淺談陽和湯加天仙子治療慢性化膿性骨髓炎的臨床運用. 時珍國醫國藥, 2008, 19(1): 200-201.
11.	張亮, 陳統一. 載藥磷酸鈣骨水泥研究進展. 國際骨科學雜志, 2012, 33(4):228-233.
12.	Chen K, Balloch R. Management of calcaneal osteomyelitis. Clin Podiatr Med Surg, 2010, 27(3): 417-429.
13.	何源龍, 鄭欣, 陳一心. 抗感染材料應用于慢性骨髓炎治療的研究進展. 中國矯形外科雜志, 2014, 22(5): 426-429.
14.	陳文昭, 黃山虎, 劉志禮. 萬古霉素磷酸鈣骨水泥治療慢性骨髓炎療效分析. 江西醫藥, 2013, 48(2): 127-128.
15.	畢軍偉, 李盛華, 劉紅喜, 等. PMMA 與 CPC 混合萬古霉素治療慢性骨髓炎療效對比. 醫學理論與實踐, 2016, 29(6): 761-762.
16.	周健, 方濤林, 董健. 抗生素緩釋載體在慢性骨髓炎治療中的應用. 中華臨床醫師雜志: 電子版, 2011, 5(6): 1708-1711.
17.	張展, 張春, 張曉文, 等. 載萬古霉素硫酸鈣在人體內緩釋藥物的臨床研究.中國醫藥導刊, 2015, 17(12): 1247-1250.
18.	張亮. 復合磷酸鈣骨水泥改進性研究進展. 陜西醫學雜志, 2010, 39(11): 1532-1534.

1. 褚立濤. 慢性骨髓炎治療的研究進展. 醫學研究生學報, 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, 胡蘊玉, 李明全, 等. 抗感染重組合異種骨對兔脛骨骨髓炎的治療作用. 中華骨科雜志, 2003, 23(4): 230-234.
4. 楊文水. 骨髓炎. 北京: 科學技術出版社, 2000: 33-51.
5. 葉向陽, 甄平, 李曉飛, 等. 磷酸鈣骨水泥藥物緩釋體系的研究應用. 中國組織工程研究與臨床康復, 2009, 13(47): 9317-9320.
6. 葉增偉, 劉隨意, 蘇佳燦. 抗生素/磷酸鈣骨水泥載藥緩釋系統研究進展. 創傷外科雜志, 2010, 12(5): 472-474, 封 3.
7. 陳紅衛, 趙鋼生, 王子陽, 等. 一期病灶清除載藥磷酸鈣人工骨充填治療慢性骨髓炎. 臨床骨科雜志, 2008, 11(6): 512-514.
8. 趙春成, 康彥忠, 陳長春. 載萬古霉素磷酸鈣治療慢性跟骨骨髓炎療效分析. 陜西醫學雜志, 2014, 43(9): 1199-1200.
9. 張展, 張春, 郭峭峰, 等. 載萬古霉素硫酸鈣在骨髓炎治療中的應用. 中國醫學科學院學報, 2013, 35(3): 337-342.
10. 丁志軍, 唐勇, 李怡. 淺談陽和湯加天仙子治療慢性化膿性骨髓炎的臨床運用. 時珍國醫國藥, 2008, 19(1): 200-201.
11. 張亮, 陳統一. 載藥磷酸鈣骨水泥研究進展. 國際骨科學雜志, 2012, 33(4):228-233.
12. Chen K, Balloch R. Management of calcaneal osteomyelitis. Clin Podiatr Med Surg, 2010, 27(3): 417-429.
13. 何源龍, 鄭欣, 陳一心. 抗感染材料應用于慢性骨髓炎治療的研究進展. 中國矯形外科雜志, 2014, 22(5): 426-429.
14. 陳文昭, 黃山虎, 劉志禮. 萬古霉素磷酸鈣骨水泥治療慢性骨髓炎療效分析. 江西醫藥, 2013, 48(2): 127-128.
15. 畢軍偉, 李盛華, 劉紅喜, 等. PMMA 與 CPC 混合萬古霉素治療慢性骨髓炎療效對比. 醫學理論與實踐, 2016, 29(6): 761-762.
16. 周健, 方濤林, 董健. 抗生素緩釋載體在慢性骨髓炎治療中的應用. 中華臨床醫師雜志: 電子版, 2011, 5(6): 1708-1711.
17. 張展, 張春, 張曉文, 等. 載萬古霉素硫酸鈣在人體內緩釋藥物的臨床研究.中國醫藥導刊, 2015, 17(12): 1247-1250.
18. 張亮. 復合磷酸鈣骨水泥改進性研究進展. 陜西醫學雜志, 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

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content