Effectiveness of antibiotic-loaded bone cement combined with Ilizarov bone transfer technique on treatment of patients with chronic osteomyelitis caused by tibial infection
OBJECTIVE To analyze the effectiveness of antibiotic-loaded bone cement on serum transforming growth factor-β1(TGF-β1),Smad3,γ-interferon inducible protein-10(IP-10)and bone morphogenetic protein-2(BMP-2)in patients with chronic osteomyelitis caused by tibial infection.METHODS From Jun.2021 to Jun.2023,totally 98 patients with chronic osteomyelitis caused by tibial infection in Shanghai Shuguang Hospital were enrolled and divided into group A treated with Ilizarov bone transfer technique and group B treated with additional antibiotic-based bone cement through computer-generated table of random numbers with 49 cases in each group.All patients were observed for 6 weeks after operation and followed up for 3 months.The post-operative recovery and recur-rence were statistically analyzed,and the pre-and post-operative serum profiles of cytokines,inflammatory indi-cators and pain conditions were compared between the two groups.RESULTS The wound healing time,suture re-moval time,time for bone absorption and the length of stay in the group B were all shorter than those in the group A(P＜0.05).The serum levels of TGF-β1,Smad3 and BMP-2 in the two groups 6 weeks after operation were higher than those before operation(P＜0.05),and those in the group B were higher than those in the group A(P＜0.05).The serum levels of IP-10,white blood cells(WBC),neutrophils(NEU),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)after operation were lower than those before operation(P＜0.05),and those in the group B were lower than those in the group A(P＜0.05).The pain assessment scores of group A and B were contrasted at the time point of after 2,6 weeks and 3 months after operation,they showed a decreasing trend in both groups(F=205.378,342.284,P＜0.001,respectively),and scores in group B was lower than those in group A(P＜0.05).CONCLUSIONS Antibiotic-loaded bone cement combined with Ilizarov bone transfer tech-nique can effectively decrease TGF-β1,Smad3,IP-10 and BMP-2 levels,reduce the inflammatory reaction and pains.It contributes to condition improvement and postoperative recovery,meanwhile,brings good clinical effect and decreased postoperative recurrence.
Chronic osteomyelitisInfectionTibiaAntibiotic bone cementIlizarov bone transfer techniqueTransforming growth factor-β1Smad3γ-interferon inducible protein 10Bone morphogenetic protein-2
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