Utility of Antibiotic-Loaded Dicalcium Phosphate Dehydrate/β-Tricalcium Phosphate in the Surgical Treatment of Diabetic FootOsteomyelitis
10.4055/jkoa.2024.59.4.301
- Author:
Tae-ho KIM
1
;
Byeong-heon CHOI
;
Jong-kil KIM
Author Information
1. Department of Orthopaedic Surgery, Presbyterian Medical Center, Jeonju, Korea
- Publication Type:Original Article
- From:The Journal of the Korean Orthopaedic Association
2024;59(4):301-307
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This retrospective study evaluated the effectiveness and healing outcomes of antibiotic-loaded dicalcium phosphate dehydrate/ β-tricalcium phosphate (β-TCP/DCPD) compared to antibiotic-loaded polymethylmethacrylate (PMMA) cement in the treatment of diabetic foot osteomyelitis (DFO).
Materials and Methods:The study examined 31 patients diagnosed with DFO from 2019 to 2021. The participants underwent surgical debridement accompanied by systemic antibiotic therapy, applying either antibiotic-loaded PMMA beads (group P, n=20) or antibiotic-loaded β-TCP/DCPD beads (group N, n=11). The assessment criteria included the Cierny-Mader and C-M Host classification for osteomyelitis, Wagner Diabetic Foot Ulcer classification, and the parameters for nonvascular surgical treatment.
Results:The healing rates were 95% and 100% in groups P and N, respectively (p=0.543). The median healing time was 18 and 19 weeks for groups P and N, respectively (p=0.094). Amputation was necessary for one patient (5%) in group P. The DFO recurrence rates were 10% and 9% in groups P and N, respectively (p=0.534). The median hospital stay was 34 and 31 days for groups P and N, respectively (p=0.634).In particular, postoperative antibiotic bead leakage occurred in 5% and 45% of groups P and N, respectively (p=0.006).
Conclusion:β-TCP/DCPD, as a drug delivery system, is an effective adjunct for treating deep diabetic foot infections. Nevertheless, the higher incidence of surgical site antibiotic bead leakage with β-TCP/DCPD necessitates careful consideration of its application.
