DOI QR코드

DOI QR Code

Osteomyelitis Treated with Antibiotic Impregnated Polymethyl Methacrylate

  • Li, Hsueh-Yu (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital) ;
  • Yoon, Kyu-Ho (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital) ;
  • Park, Kwan-Soo (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital) ;
  • Cheong, Jeong-Kwon (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital) ;
  • Bae, Jung-Ho (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital) ;
  • Han, Jung-Gil (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital) ;
  • Park, Hyung-Koo (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital) ;
  • Shin, Jae-Myung (Department of Oral and Maxillofacial Surgery, Inje University Ilsan Paik Hospital) ;
  • Baik, Ji-Sun (Department of Oral and Maxillofacial Surgery, Inje University Ilsan Paik Hospital)
  • 투고 : 2013.08.02
  • 심사 : 2013.11.26
  • 발행 : 2013.11.30

초록

Chronic osteomyelitis is an infection and inflammation of the bone or bone marrow, causing ischemia in bone marrow due to lack of blood, nutrients, and oxygen supply to the bone marrow, eventually leading to necrosis of bone marrow. A current method for treatment of chronic osteomyelitis is administration of systemic antibiotics followed by removal of the infected bone and tissues. Because infected tissue of chronic osteomyelitis is surrounded by avascular necrotic bone, supply of blood and antibiotics to the infected area is diminished. For effective treatment, high plasma concentrations of antibiotics should be provided for a prolonged period. However, long term high serum level of antibiotics may result in undesirable adverse effects. For delivery of a sufficient concentration of antibiotic to the infected area while avoiding the adverse effect, implantation of a local antibiotic delivery system is suggested. One of the implantation systems that has been utilized is antibiotic impregnated polymethyl methacrylate.

키워드

참고문헌

  1. Buchholz HW, Engelbrecht H. Depot effects of various antibiotics mixed with Palacos resins. Chirurg 1970;41:511-5.
  2. Klemm K. Treatment of chronic bone infections with gentamicin- PMMA chains and beads. Accid Surg 1976;1:20-5.
  3. Coviello V, Stevens MR. Contemporary concepts in the treatment of chronic osteomyelitis. Oral Maxillofac Surg Clin North Am 2007;19:523-34. https://doi.org/10.1016/j.coms.2007.07.001
  4. Grime PD, Bowerman JE, Weller PJ. Gentamicin impregnated polymethyl methacrylate (PMMA) beads in the treatment of primary chronic osteomyelitis of the mandible. Br J Oral Maxillofac Surg 1990;28:367-74. https://doi.org/10.1016/0266-4356(90)90033-H
  5. Chisholm BB, Lew D, Sadasivan K. The use of tobramycinimpregnated polymethyl methacrylate beads in the treatment of osteomyelitis of the mandible: report of three cases. J Oral Maxillofac Surg 1993;51:444-9. https://doi.org/10.1016/S0278-2391(10)80366-0
  6. Levin PD. The effectiveness of various antibiotics in methyl methacrylate. J Bone Joint Surg Br 1975;57:234-7.
  7. Picknell B, Mizen L, Sutherland R. Antibacterial activity of antibiotics in acrylic bone cement. J Bone Joint Surg Br 1977;59:302-7.
  8. Anagnostakos K, Fürst O, Kelm J. Antibiotic-impregnated PMMA hip spacers: Current status. Acta Orthop 2006;77:628-37. https://doi.org/10.1080/17453670610012719
  9. Masri BA, Duncan CP, Beauchamp CP. Long-term elution of antibiotics from bone-cement: an in vivo study using the prosthesis of antibiotic-loaded acrylic cement (PROSTALAC) system. J Arthroplasty 1998;13:331-8. https://doi.org/10.1016/S0883-5403(98)90179-6
  10. Anagnostakos K, Kelm J, Regitz T, Schmitt E, Jung W. In vitro evaluation of antibiotic release from and bacteria growth inhibition by antibiotic-loaded acrylic bone cement spacers. J Biomed Mater Res B Appl Biomater 2005;72:373-8.
  11. Anagnostakos K, Wilmes P, Schmitt E, Kelm J. Elution of gentamicin and vancomycin from polymethyl methacrylate beads and hip spacers in vivo. Acta Orthop 2009;80:193-7. https://doi.org/10.3109/17453670902884700