Treatment for Staphylococcus aureus infection following open wedge high tibial osteotomy using antibiotic-impregnated calcium phosphate cement

Knee Surg Sports Traumatol Arthrosc. 2014 Nov;22(11):2614-7. doi: 10.1007/s00167-013-2460-9. Epub 2013 Mar 5.

Abstract

This report describes a case of Staphylococcus aureus infection following open wedge high tibial osteotomy, which was successfully treated with by implant removal and replacement with antibiotic-impregnated calcium phosphate cement along with external fixation. The infection occurred 7 months after primary surgery and was treated by implant removal, debridement, external fixation, and application of vancomycin impregnated calcium phosphate cement to fill the defect. Subsequently, the infection resolved completely, and the osteotomy healed with no correction loss. Compared with conventional bone cement, calcium phosphate cement might be an optimal material for certain cases of infection after open wedge high tibial osteotomy because of its higher antibiotic retention, biocompatibility, osteoconductivity, and compatibility with heatlabile antibiotics.

Level of evidence: V.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Bone Cements
  • Calcium Phosphates
  • Debridement
  • Device Removal
  • Female
  • Fracture Fixation
  • Humans
  • Middle Aged
  • Osteoarthritis, Knee / surgery*
  • Osteotomy / adverse effects*
  • Staphylococcal Infections / etiology
  • Staphylococcal Infections / therapy
  • Staphylococcus aureus*
  • Tibia / surgery*
  • Vancomycin / administration & dosage

Substances

  • Anti-Bacterial Agents
  • Bone Cements
  • Calcium Phosphates
  • Vancomycin
  • calcium phosphate