First experience with the use of a partially bioresorbable bone substitution material in a patient with 34-year old chronic osteomyelitis of the tibia

Introduction The most common approach to the treatment of osteomyelitic cavities (Cierny – Mader type III) is a two-stage approach proposed by Masquelet, the main shortcoming of which is the need to perform a second surgical intervention which results in a longer rehabilitation period, increased economic costs and additional emotional distress of the patient. In electronic databases, we found 17 publications devoted to the use of partially bioresorbable materials for filling in uncomplicated bone defects. The experience of treatment of chronic osteomyelitis (Cierny – Mader type III) using such materials has not been described. Purpose Demonstration of the first use of a partially bioresorbable osteosubstituting material in a one‑stage treatment of a patient with a long-term osteomyelitic process after failures of conventional surgical treatment methods. Materials and methods We present a case of a 54-year old patient with a diagnosis of chronic post-traumatic osteomyelitis of the right leg, fistulous form, associated with contracture of the right ankle joint, 2-cm shortening of the right lower limb. A one-stage treatment technique was used using a partially bioresorbable osteosubstituting material for the first time in combination with antibacterial drugs, preselected in accordance with the patient's microbial cultures. Results The study evaluated the use of a partially bioresorbable material impregnated with antibacterial drugs in the treatment of a patient with osteomyelitic cavity Cierny – Mader type III that achieved stable arrest of purulent and inflammatory process. Discussion The mandatory two-stage Masquelet approach increases the surgical aggression, requires collection of an autologous bone graft, thus the risk of possible complications becomes higher. The obvious advantages of bioresorbable materials impregnated with antibacterial drugs to fill in bone defects are: no need to collect an autograft, a reduction in the number of surgical interventions to one, the possibility of gradual natural degradation of the implant from the patient's body due to bioresorption. Conclusion The study demonstrates the potential use of partially bioresorbable materials in a one-stage technology for treating patients with Cierny – Mader type III osteomyelitic cavities.