Use of bioactive glass in acute osteomyelitis treatment in a pediatric patient
Keywords:
acute osteomyelitis, BAG-S53P4, pediatric patient, biomaterial, treatment.Abstract
Introduction: Osteomyelitis is a serious disease in children, which requires early diagnosis and treatment to minimize sequelae. The use of bioactive glass is considered an alternative to fill bone defects after curettage and debridement of chronic osteomyelitis. However, to date there are no data on its use in the treatment of acute osteomyelitis in the pediatric population.
Objective: To describe the results of the use of bioactive glass when treating a pediatric patient with acute osteomyelitis.
Case report: An eight-year-old patient, with acute osteomyelitis of the tibia due to methicillin-resistant S. aureus, received intravenous antibiotic therapy and surgical management for local control; however, due to poor clinical response, bioactive glass (BAG-S53P4 BonAlive® Granules, Finland) had to be used. She evolved with excellent clinical and paraclinical results, and complete osseointegration of the biomaterial in a three-year follow-up.
Conclusions: The BAG-S53P4 bioactive glass was an effective bone substitute, with excellent long-term results, without side effects in the treatment of a pediatric patient with acute osteomyelitis; nonetheless additional studies are required.
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References
Howard AR, Isaacs D. Systematic review of duration and choice of systemic antibiotics therapy for acute haematogenous bacterial osteomyelitis in children. J Paed Child Health 2013;49(9):760-8. DOI: https://doi.org/10.1111/jpc.12251 2. Chiappini E, Mastrangelo G, Lazzeri S. A case of acute osteomyelitis: An update on diagnosis and treatment. Int J Environ Res Public Health. 2016;13(6):539. DOI: https://doi.org/10.3390/ijerph13060539
Yeo A, Ramachandran M. Acute haematogenous osteomyelitis in children. BMJ. 2014;348:g66. DOI: https://doi.org/10.1136/bmj.g66
Russell CD, Ramaesh R, Kalima P, Murray A, Gaston MS. Microbiological characteristics of acute osteoarticular infections in children. J Med Microbiol. 2015;64(4):446-53. DOI: https://doi.org/10.1099/jmm.0.000026
Thomsen I, Creech CB. Advances in the diagnosis and management of pediatric osteomyelitis. Curr Infect Dis Rep. 2011;13(5):451-60. DOI: https://doi.org/10.1007/s11908-011-0202-z
Drago L. A modern approach to biofilm-related orthopaedic implant infections. New York NY: Springer; 2017.
Ochsner PE, Borens O, Bodler PM, Brogger I, Eich G, Hefti F, et al. Infections of the musculoskeletal system-Basic principles, prevention, diagnosis and treatment. Grandvaux, Switzerland: Swiss orthopaedics and the Swiss Society for Infectious Diseases expert group “Infections of the musculoskeletal system”; 2016.
Ziegenhain F, Neuhaus V, Pape HC. Bioactive glass in the treatment of chronic osteomielitis-a valid option? OTA Int. 2021;4(3):105-6. DOI: https://doi.org/10.1097/OI9.0000000000000105
Ferrando A, Part J, Baeza J. Treatment of cavitary bone defects in chronic osteomyelitis: bioactive glass S53P4 vs. calcium sulphate antibiotic beads. J Bone Jt Infect. 2017;2(4):194-201. DOI: https://doi.org/10.7150/jbji.20404
Ronga M, Ferraro S, Fagetti A, Cherubino M, Valdatta L, Cherubino P. Masquelet technique for the treatment of a severe acute tibial bone loss. Injury. 2014;45(supl6):s111-5. DOI: https://doi.org/10.1016/j.injury.2014.10.033
Mühlhäusser J, Winkler J, Babst R, Beereers S. Infected tibia defect fractures treated with the Masquelet technique. Med. 2017;96(20):e6948. DOI: https://doi.org/10.1097/MD.0000000000006948
Ryan EJ, Ryan AJ, González A, Philippart A, Ciraldo F, Hobss C, et al. Collagen scaffolds functionalised with copper-eluting bioactive glass reduce infection and enhance osteogenesis and angiogenesis both in vitro and in vivo. Biomat. 2019;197:405-16. DOI: https://doi.org/10.1016/j.biomaterials.2019.01.031
Day RM. Bioactive glass stimulates the secretion of angiogenic growth factors and angiogenesis in vitro. Tissue Eng. 2005;11(5-6):768-77. DOI: https://doi.org/10.1089/ten.2005.11.768
Rahaman MN, Day DE, Bal BS, Fu Q, Jung S, Bonewald S, et al. Bioactive glass in tissue engineering. Acta Biomat. 2011;7(6):2355-73. DOI: https://doi.org/10.1016/j.actbio.2011.03.016
Peltola T, Jokinen M, Rahiala H, Levänen E, Rosenholm J, Kangasniemi J, et al. Calcium phosphate formation on porous sol-gel-derived SiO2 and CaO-P2O5-SiO2 substrates in vitro. J Biomed Mater Res. 1999;44(1):12-21. DOI: https://doi.org/10.1002/(SICI)1097-4636(199901)44:1%3C12::AID-JBM2%3E3.0.CO;2-E
Pereira MM, Clark AE, Hench LL. Calcium phosphate formation on solgel-derived bioactive glasses in vitro. J Biomed Mater Res. 1994;28(6):693-8. DOI: https://doi.org/10.1002/jbm.820280606
van Vugt TA, Geurts JAP, Arts JJC, Lindfors NC. Biomaterials in treatment of orthopedic infections. PJIs. 2017;41-68. DOI: https://doi.org/10.1016/B978-0-08-100205-6.00003-3
Lindfors N, Geurts J, Drago L, Arts JJ, Juutilainen V, Hyvönen P, et al. Antibacterial bioactive glass, S53P4, for chronic bone infections - a multinational study. Adv Exp Med Biol. 2017;971:81-92. DOI: https://doi.org/10.1007/5584_2016_156
Gonzalez M, Butini ME, Maiolo EM, Sessa L, Trampuz A. Antimicrobial activity of bioactive glass S53P4 against representative microorganisms causing osteomyelitis - Real-time assessment by isothermal microcalorimetry. Coll Surf B Bioint. 2020;189:110853. DOI: https://doi.org/10.1016/j.colsurfb.2020.110853
Bigoni M, Turati M, Zanchi N, Lombardo AS, Graci J, Omeljaniuk RJ, et al. Clinical applications of Bioactive glass S53P4 in bone infections: a systematic review. Eur Rev Med Pharmacol Sci. 2019;23(2supl):240-51. DOI: https://doi.org/10.26355/eurrev_201904_17498
Tanwar YS, Ferreira N. The role of bioactive glass in the management of chronic osteomyelitis: a systematic review of literature and current evidence. Infect Dis (Lond). 2020;52(4):219-26. DOI: https://doi.org/10.1080/23744235.2019.1695059
Cossio A, Graci J, Lombardo AS, Turati M, Melzi ML, Bigoni M, et al. Bilateral tibial Brodie’s abscess in a young patient treated with BAG-S53P4: case report. Ital J Pediatr. 2019;45(1):91. DOI: https://doi.org/10.1186/s13052-019-0685-z
