한국임상수의학회지 (Journal of Veterinary Clinics)

  • 제33권5호
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  • Pages.300-303
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  • 2016
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  • 1598-298X(pISSN)
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  • 2384-0749(eISSN)
한국임상수의학회 (The Korean Society of Veterinary Clinics)
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One-Stage Treatment of Chronic Calcaneal Osteomyelitis with Bone Morphogenetic Protein 2 and Local Antibiotic Delivery in a Cat

  • Kim, Hyungkyoo (College of Veterinary Medicine, Chungnam National University) ;
  • Jeong, Heejun (College of Veterinary Medicine, Chungnam National University) ;
  • Park, Chul (BK21 Plus Team and College of Veterinary Medicine, Chonbuk National University) ;
  • So, Kyung-Min (Animal Nutrition and Physiology Team, National Institute of Animal Science, Rural Development Administration) ;
  • Park, Jiyoung (College of Veterinary Medicine, Chungnam National University) ;
  • Jeong, Seong Mok (College of Veterinary Medicine, Chungnam National University) ;
  • Lee, Haebeom (College of Veterinary Medicine, Chungnam National University)
  • 투고 : 2016.05.31
  • 심사 : 2016.08.16
  • 발행 : 2016.10.31
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초록

An age-unknown, 4.8 kg, male, wild, domestic short-hair cat was presented for left hindlimb lameness. A physical examination revealed a draining tract which was suspected of bite on left calcaneal bone. The left tarsal joint was markedly swollen and exudates were observed around the draining tract. Sequestrum at left calcaneus bone, and osteolysis were identified by radiography. The sequestrum and its surrounding exudative tissue were debrided during surgery and the tissue was submitted for bacterial culture and sensitivity test. The debridement caused a bone defect ($1.5cm{\times}0.5cm{\times}0.5cm$) on the medial left calcaneal bone. Plate and screw fixation was performed to the calcaneus bone as buttress plate. Recombinant human bone morphogenetic protein-2 (rhBMP-2) loaded hydroxyapatite was implanted in the bone defect. Furthermore, Amikacin-impregnated collagen sponges were also placed around bone plate to deliver local antibiotics. A systemic antibiotic treatment regimen based on bacterial culture and sensitivity test results was administered for 4 weeks. The wound properly healed without any signs of infection, and the bone healing was confirmed by radiography. The patient showed normal weight bearing ambulation at 18 weeks after surgery. The use of rhBMP-2 and local antibiotic delivery system is a good surgical option for the one-stage treatment of chronic osteomyelitis.

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참고문헌

  1. Anagnostakos K, Schroder K. Antibiotic-impregnated bone grafts in orthopaedic and trauma surgery: a systematic review of the literature. Int J Biomater 2012; 2012: 538061
  2. Arzi B, Verstraete FJM, Huey DJ, Cissell DD, Athanasiou KA. Regenerating Mandibular Bone Using rhBMP-2: Part 1-Immediate Reconstruction of Segmental Mandibulectomies. Vet Surg 2015; 44: 403-409. https://doi.org/10.1111/j.1532-950X.2014.12123.x
  3. Bhattacharya R, Kundu B, Nandi SK, Basu D. Systematic approach to treat chronic osteomyelitis through localized drug delivery system: bench to bed side. Mater Sci Eng C Mater Biol Appl 2013 33: 3986-3993. https://doi.org/10.1016/j.msec.2013.05.036
  4. Budsberg SC. Osteomyelitis. In: Veterinary Surgery: Small Animal, 1st ed. St. Louis: Saunders Elsevier. 2012: 669-675.
  5. Choi HR, Kwon YM, Freiberg AA, Malchau H. Comparison of one-stage revision with antibiotic cement versus twostage revision results for infected total hip arthroplasty. J Arthroplasty 2013; 28: 66-70. https://doi.org/10.1016/j.arth.2013.02.037
  6. Guelinckx PJ, Sinsel NK. Refinements in the one-stage procedure for management of chronic osteomyelitis. Microsurgery 1995; 16: 606-611. https://doi.org/10.1002/micr.1920160906
  7. Hayes G, Moens N, Gibson T. A review of local antibiotic implants and applications to veterinary orthopaedic surgery. Vet Comp Orthop Traumatol 2013; 26: 251-259. https://doi.org/10.3415/VCOT-12-05-0065
  8. Ikpeme IA, Oku EO, Ngim NE, Ilori IU, Abang IE. Comparison of the outcome of treatment of chronic osteomyelitis by surgical debridement with and without local antibiotic delivery system: experience from a nigerian teaching hospital. Int J Clin Med 2013; 4: 313-318. https://doi.org/10.4236/ijcm.2013.47055
  9. Jenny JY, Lengert R, Diesinger Y, Gaudias J. Routine onestage exchange for chronic infection after total hip replacement. Int Orthop 2014 38: 2477-2481. https://doi.org/10.1007/s00264-014-2466-z
  10. Kirker-Head CA, Boudrieau RJ, Kraus KH. Use of bone morphogenetic proteins for augmentation of bone regeneration. J Am Vet Med Assoc 2007; 231: 1039-1055. https://doi.org/10.2460/javma.231.7.1039
  11. Klouche S, Leonard P, Zeller V, Lhotellier L, Graff W, Leclerc P, Mamoudy P, Sariali E. Infected total hip arthroplasty revision: one-or two-stage procedure?. Orthop Traumatol Surg Res 2012; 98: 144-150. https://doi.org/10.1016/j.otsr.2011.08.018
  12. Lei H, Yi L. One-stage open cancellous bone grafting of infected fracture and nonunion. J Orthop Sci 1998; 3: 318-323. https://doi.org/10.1007/s007760050059
  13. Lo KWH, Ulery BD, Ashe KM, Laurencin CT. Studies of bone morphogenetic protein-based surgical repair. Adv Drug Deliv Rev 2012; 64: 1277-1291. https://doi.org/10.1016/j.addr.2012.03.014
  14. Rudelli S, Uip D, Honda E, Lima ALL. One-stage revision of infected total hip arthroplasty with bone graft. J Arthroplasty 2008; 23: 1165-1177. https://doi.org/10.1016/j.arth.2007.08.010
  15. Schulz KS. Osteomyelitis. In: Small Animal Surgery. 4th ed. St. Louis: Mosby Elsevier, 2013: 1407-1410.
  16. Tibrewal S, Malagelada F, Jeyaseelan L, Posch F, Scott G. Single-stage revision for the infected total knee replacement results from a single centre. Bone Joint J 2014; 96: 759-764.
  17. Uckay I, Jugun K, Gamulin A, Wagener J, Hoffmeyer P, Lew D. Chronic osteomyelitis. Curr Infect Dis Rep 2012; 14: 566-575. https://doi.org/10.1007/s11908-012-0286-0
  18. Verstraete FJM, Arzi B, Huey DJ, Cissell DD, Athanasiou KA. Regenerating Mandibular Bone Using rhBMP-2: Part 2-Treatment of Chronic, Defect Non-Union Fractures. Vet Surg 2015; 44: 410-416. https://doi.org/10.1111/j.1532-950X.2014.12122.x
  19. Waldvogel FA, Medoff G, Swartz MN. Osteomyelitis: a review of clinical features, therapeutic considerations and unusual aspects. New Engl J Med 1970; 282: 198-206. https://doi.org/10.1056/NEJM197001222820406
  20. Walter G, Kemmerer M, Kappler C, Hoffmann R. Treatment algorithms for chronic osteomyelitis. Dtsch Arztebl Int 2012; 109: 257-64.
  21. Wolf CF, Gu NY, Doctor JN, Manner PA, Leopold SS. Comparison of one and two-stage revision of total hip arthroplasty complicated by infection. J Bone Joint Surg Am 2011; 93: 631-639. https://doi.org/10.2106/JBJS.I.01256