Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Dec;54(6):627-635.
doi: 10.1016/j.rbo.2017.12.013. Epub 2019 Dec 13.

Postoperative Chronic Osteomyelitis in the Long Bones - Current Knowledge and Management of the Problem

Lourenço Galizia Heitzmann  1 , Raphael Battisti  1 , Ayres Fernando Rodrigues  1 , Juliano Valente Lestingi  1 , Cinthya Cavazzana  1 , Roberto Dantas Queiroz  1
Affiliations

Postoperative Chronic Osteomyelitis in the Long Bones - Current Knowledge and Management of the Problem

Lourenço Galizia Heitzmann et al. Rev Bras Ortop (Sao Paulo). 2019 Dec.

Abstract

Chronic postoperative osteomyelitis represents an important health problem due to its significant morbidity and low mortality rate. This pathology is challenging because of difficulties in understanding the pathogenesis and the decision-making involving the treatment. The present article had the goal of reviewing the definition, pathogenesis, clinical aspects, diagnosis, and treatment of chronic postoperative osteomyelitis, and of gathering this information in a single Brazilian updated publication. The PubMed, LILACS, and the Cochrane Library medical databases were analyzed using pertinent keywords. Current and relevant articles were selected. The present article gathered the established information, as well as innovations related to chronic osteomyelitis and its treatment, to offer updated data to assist the professionals involved in the management of chronic osteomyelitis.

Keywords: bacterial infections; osteomyelitis; postoperative complications.

PubMed Disclaimer

Conflict of interest statement

Conflitos de Interesse Os autores declaram não haver conflitos de interesse.

Figures

Fig. 1
Fig. 1
Cierny and Mader classification for osteomyelitis according to the pattern of bone involvement. Type 1, spinal cord; type 2, superficial; type 3, stable permeative; type 4, unstable permeative osteomyelitis.
Fig. 2
Fig. 2
Structural model of bacterial biofilm. Note the presence of bacterial superficial lamina adhered to the metallic material, the protein tower structure filled with bacteria in transit, the fluid at the base of the towers, and protein strips enabling bacterial transit. Planktonic bacteria are present around the biofilm.
Fig. 3
Fig. 3
Interaction phenomena between the infectious tissue and the host result in bone sequestration and fistula formation.
Fig. 1
Fig. 1
Classificação de Ciernye Mader para osteomielite quanto ao padrão de acometimento ósseo. Tipo 1, medular; tipo 2, superficial; tipo 3, permeativa estável; tipo 4, permeativa instável.
Fig. 2
Fig. 2
Modelo estrutural do biofilme bacteriano. Notar a presença de lâmina superficial bacteriana aderida ao material metálico, a estrutura proteica de torres com bactérias em trânsito em seu interior, o fluido líquido na base das torres, e as fitas proteicas que permitem o trânsito bacteriano. Há a presença de bactérias planctônicas em volta do biofilme.
Fig. 3
Fig. 3
Fenômenos de interação entre o tecido infeccioso e o hospedeiro levam à formação de sequestro ósseo e fístula.
See this image and copyright information in PMC

References

    1. Mast N H, Horwitz D. Osteomyelitis: a review of current literature and concepts. Oper Tech Orthop. 2002;12(04):232–241.
    1. Lima A LLM, Zumiotti A V. Aspectos atuais do diagnóstico e tratamento das osteomielites. Acta Ortop Bras. 1999;7(03):135–142.
    1. Lew D P, Waldvogel F A.Osteomyelitis Lancet 2004364(9431):369–379. - PubMed
    1. Cierny G, Mader J T. Thorofare, NJ: Slack; 1989. Adult chronic osteomyelitis. A review; pp. 31–48.
    1. Cierny G, III, Mader J T, Penninck J J.A clinical staging system for adult osteomyelitis Clin Orthop Relat Res 2003; (4147–24. - PubMed