Outcomes following use of large diameter antibiotic coated threaded rod for treatment of osteomyelitis

<h2>Abstract</h2> The treatment of large bony defects secondary to osteomyelitis in the lower extremity continues to be a challenge in reconstructive surgery. Surgical treatment for osteomyelitis in long bones commonly entails resection of the infected portion of bone, but this often leaves a large bony defect. Masquelet technique has been successfully used in the treatment of osteomyelitis through the concept of induced membrane and the use of antibiotic impregnated polymethylmethacrylate (PMMA) cement. This retrospective case study evaluates the clinical and radiographic outcomes of using a staged approach in the treatment of lower extremity osteomyelitis in 14 patients using an intramedullary antibiotic coated threaded rod. Measured outcomes include time to radiographic fusion (5.1 weeks), time to weight bearing (3.2 weeks), hardware removal (7.14%), need for revision surgery (7.14%), and complications (35.71%). Our findings support the use of a staged approach using a large antibiotic rod prior to definitive fixation as a mode of successfully treating lower extremity osteomyelitis and aiding in joint fusion.