Use of antibiotic cement spacers/beads in treatment of musculoskeletal infections at A.I.C. Kijabe Hospital

Abstract

Background: Chronic musculoskeletal infection involving bone present a big challenge to orthopaedic surgeons. These include chronic osteomyelitis, septic non union and open fractures of long bones.

Objective: The study was done to determine outcome of treatment of chronic musculoskeletal infections involving bone after use of local antibiotic impregnated cement and report the microbiological patterns of these infections in our hospital.

Setting: A.I.C. Kijabe Hospital, Kenya.

Patients and methods: The medical charts of all patients treated with antibiotic cement were reviewed over the period of one year [September 2012 to September 2013]. The cohort consisted of 80% males and 20% females. The patterns of cultures for infections were reviewed and the procedure of antibiotic impregnated cement placement described.

Results: Twenty patients charts were reviewed, 4 (20%) were females and 16 (80%) males with ages ranging between 4 years and 62 years. Of these 40% had infected non unions of tibiae and femur, 25% open fractures, 25% chronic osteomyelitis. Culture results revealed 25% mixed infections, 20% staphylococcus aureus. All patients had initial debridement and antibiotic impregnated bone cement. Infection was cleared in 95% of the patients with 75% having radiological evidence of healing. Forty percent had bone transport of between 4 and 6 cm. A 100% of the patients had negative cultures at the time of antibiotic cement spacers removal.

Conclusions: Use of antibiotic impregnated bone cement could be used in treating chronic musculoskeletal infections.