The Results of Synthetic Pure Calcium Sulfate Impregnated with Antibiotic in the Management of Bone Infections and Non-unions

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Volume 7 | Issue 2 | May – Aug 2019 | Page: 22-26 | Keith B. Tamboowalla, Jaison Thomas, Madan Mohan M, Anoop Pilar, Belliappa C P, Rajkumar S Amaravathi

Authors: Keith B. Tamboowalla [1], Jaison Thomas [2], Madan Mohan M [3], Anoop Pilar [3], Belliappa C P [3], Rajkumar S Amaravathi [3].

[1] Department of Orthopaedics, St Johns Medical College Hospital, Bengaluru, Karnataka.

Address of Correspondence
Dr. Dr. Rajkumar S Amaravathi,
Professor and Unit Head,
Department of Orthopaedics, St Johns Medical College Hospital, Bengaluru, Karnataka.
E-mail: rajkumar_as@yahoo.co.in

Abstract

Background: The problems in treating bone infections and non-unions of the bone continue to plague orthopedic practice. The authors present a retrospective analysis with the purpose of evaluating the outcome of infections and non-unions treated with antibiotic-impregnatedcalcium sulfate (AICS).
Materials and Methods: We assessed the outcomes of 25 patients who were operated between May 2014 and May 2017 for osteomyelitis (9) and long bone non-union (16). Each patient underwent a standard surgical procedure as the situation demanded, along with instillation of AICS into the defect. The outcomes measured were the presence of infection and union.
Results: At 1-year follow-up, 8 (88.89%) of the osteomyelitis patients showed good radiographic healing and no recurrence, while one had a relapse of osteomyelitis. Fourteen (87.5%) of the non-union patients had successful union, while persistent non-union developed in twopatients. Twenty-three (92%) patients had returned to full independent activities of daily living, including 19 who had returned to unrestricted leisure activities and pre-operative employment status.
Conclusions: We report the results of the use of AICS in our series, which showed high union rates and eradication of infection. Our experience shows that the use of AICS offers numerous advantages and promises in treating these conditions, which merit further study.
Keywords: Osteomyelitis, infected non-union, calcium sulfate, bone graft substitute, Stimulan, Fracture healing

References

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How to Cite this article: Tamboowalla K B, Thomas J, Madan Mohan M, Pilar A, Belliappa C P, Amaravathi R S. The Results of Synthetic Pure Calcium Sulfate Impregnated with Antibiotic in the Management of Bone Infections and Non-unions. Journal of Karnataka Orthopaedic Association. May-Aug 2019; 7(2): 22-26

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Second Issue 2019

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Volume 7 | Issue 2 | May – August 2019 | Page: 1 | Anil k. Bhat [1][2]

Authors: Anil k. Bhat [1][2].

[1] Editor in chief, Journal of Karnataka Orthopaedic Association
[2] Department of Orthopaedics, Kasturba Medical College, Manipal,
Karnataka, India

Address of Correspondence
Dr Anil .K Bhat ,
Associate Dean, Professor, Unit of Hand and Microsurgery,
Department of Orthopaedics, Kasturba Medical College, Manipal, Karnataka, India
Manipal Academy of Higher education
E-mail: anilkbhat@yahoo.com

Dear KOA members and Readers,
We are delighted to present the second issue for the current year 2019 with some thought provoking and interesting scientific work from our authors. We take this opportunity to thank them for their support in submitting scientific articles which has made this issue possible.

The KOA journal is committed towards integrity and good clinical practice. In this issue, our authors have come up with some interesting observations which challenges conventional presumptions about some of the commonly done procedures in our clinical practice. It is commendable to observe new findings from the authors on ubiquitous issues like the use of drains in surgery, role of antibiotics in open fractures, benefits of exercises in plantar fasciitis and the changing trend towards use of newer antibiotic delivery systems in bone infections. These recommendations underscore a pressing need to develop new guidelines and norms based on evidence based medicine. This will pave a long way in helping our Orthopaedic fraternity in offering a comprehensive and meaningful treatment for our patients who now seek more transparency in information and therapeutic options due to their easy access to internet and social media.

Presence of uniform clinical guidelines would be an important step towards gaining confidence of our patients and sealing the element of trust in the doctor- patient relationship. As we move towards a society where government sponsored medical insurance like the Ayushman Bharat will have a significant influence on the cost of medical treatment, a lack of accountability in what we convey will only add on to our vulnerabilities. This has been shown with alarming regularity in social media as the general public keeps reading about the increase in breach of trust with the medical profession. Use of such clinical guidelines would improve the respect and integrity of our profession and protect us from future medico legal liabilities. It is heartening to see the Kerala government has taken an initiative to come up with establishing clinical guidelines for primary health care at level one centres. (https://kerala.gov.in/documents/10180/12e34345-edee-4cb1-afb9-7c44b8a907c4).

We must wholeheartedly support such initiatives and take it up in our association too. One additional way would be to foster scientific temper in our society by encouraging more academic work, meetings and educational programs. More importantly, let us read more of literature in our field which should inspire us to produce genuine original work as has been done by many of the member authors in the current and past issues.

Editorial team hopes to receive further support with original scientific work from all our members and readers for future publications as we move towards an era where authentic data reigns supreme.
Thanking you and wishing you all a very happy Deepavali.

Yours sincerely,
Dr Anil .K Bhat

How to Cite this article: Bhat A K. Editorial. Journal of Karnataka Orthopaedic Association. May-Aug 2019;
7(2): 1.

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