J Bone Jt Infect 2019; 4(5):245-253. doi:10.7150/jbji.38373

Review

Current Insights in the Application of Bone Grafts for Local Antibiotic Delivery in Bone Reconstruction Surgery

Arne Peeters1, Guy Putzeys2, Lieven Thorrez3✉

1. Faculty of Medicine, KU Leuven, Leuven, Belgium
2. Orthopedic Centre, AZ Groeninge, Kortrijk, Belgium
3. Department of Development and Regeneration, KU Leuven, Kortrijk, Belgium

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Citation:
Peeters A, Putzeys G, Thorrez L. Current Insights in the Application of Bone Grafts for Local Antibiotic Delivery in Bone Reconstruction Surgery. J Bone Jt Infect 2019; 4(5):245-253. doi:10.7150/jbji.38373. Available from http://www.jbji.net/v04p0245.htm

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Abstract

Introduction: Bone implant related infection is still one of the biggest challenges in bone and joint surgery. Antibiotic impregnated bone grafts seem to be promising in both treatment and prevention of these infections. However, great variance in methodology predominates this field of research. This paper gives an overview of the published literature.

Methods: The PRISMA-flowchart was used as protocol for article selection. Medline was searched and articles were selected in accordance with predetermined exclusion criteria.

Results: Forty-eight articles were included in the synthesis. Topics including bone graft type, manipulations of the graft, elution profile, bacterial inhibition, osteotoxicity, incorporation, special impregnation methods, clinical use and storage were investigated.

Therapeutically, high initial levels seem appropriate for biofilm eradication. A single stage procedure in the treatment of bone implant related infection seems feasible. Prophylactically, the literature indicates a reduction of postoperative infections when using antibiotic impregnated bone grafts.

Conclusion: Bone grafts are a suitable carrier for local antibiotic application both therapeutically and prophylactically.

Keywords: bone grafts, impregnation, antibiotic delivery, infection