Calcium sulphate delivery system with tobramycin for the treatment of chronic calcaneal osteomyelitis |
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Authors: | Papagelopoulos P J Mavrogenis A F Tsiodras S Vlastou C Giamarellou H Soucacos P N |
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Affiliation: | First Department of Orthopaedics, Athens University Medical School, Attikon University Hospital, Athens, Greece. pjp@hol.gr |
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Abstract: | The case of a 24-year-old woman with Pseudomonas aeruginosa and Proteus mirabilis chronic calcaneal osteomyelitis is presented. Extensive debridement of the necrotic bone and application of tobramycin-loaded polymethylmethacrylate beads was performed and ciprofloxacin was given post-operatively. Three months later, laboratory tests, including complete blood cell count, erythrocyte sedimentation rate and C-reactive protein, were normal. At this time, extensive surgical debridement and filling of the osseous defect with autologous iliac cancellous bone graft and tobramycin-impregnated calcium sulphate pellets and paste were performed. Oral ciprofloxacin was administered for 3 months after surgery. At the latest follow-up, 2 years later, the patient had full weight-bearing function; there was no recurrence of the infection, and complete incorporation of the autologous bone and calcium sulphate graft with the host bone was observed. This case demonstrates that two-stage surgical treatment with extensive debridement and tobramycin-impregnated calcium sulphate was effective in treating chronic calcaneal osteomyelitis. |
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