Use of contemporary biomaterials in chronic osteomyelitis treatment: Clinical lessons learned and literature review

Abstract

Chronic osteomyelitis has always been a therapeutic challenge for patient and surgeon due to the specific problems related with bone infection and bacterial biofilm eradication. Other than being the cause of infection or facilitating spread or persistence of infection, biomaterials are also becoming a tool in the treatment of infection. Certain novel biomaterials have unique and ideal properties that render them perfectly suited to combat infection and are therefore used more and more in the treatment of chronic bone infections. In case of infection treatment, there is still debate whether these properties should be focused on bone regeneration and/or their antimicrobial properties. These properties will be of even greater importance with the challenge of emerging antimicrobial resistance. This review highlights indications for use and specific material properties of some commonly used contemporary biomaterials for this indication as well as clinical experience and a literature overview.

Keywords: biomaterials; infection.

Figure 1

MRI and radiographic view of a Cierny I endomedullary osteomyelitis of the distal tibia (anterolateral). MRI, magnetic resonance imaging [Color figure can be viewed at wileyonlinelibrary.com]

Figure 2

Chronic osteomyelitis of the radial bone, showing complete involvement of cortex and intramedullary canal (Cierny IV)