Comparison Of The Effects Of Two Surgical Procedures For Chronic Tibial Osteomyelitis

Objective: To explore the clinical outcome of two commonly used surgical procedures-bone transport and vancomycin-loaded bone cement implantation-in the treatment of chronic tibial osteomyelitis,in an effort to provide a basis for the selection of different surgical procedures for the treatment of chronic tibial osteomyelitis.Methods: A total of 51 patients with chronic tibial osteomyelitis who received bone transport and vancomycin-loaded bone cement implantation from January 2010 to January 2018 in our hospital were included.According to the surgical procedure,patients were divided into Group A(n=22,15 males and 7 females),with bone transport and Group B(n=29,21 males and 8 females),with vancomycin-loaded bone cement implantation.After performing complete debridement for focus,the operation time,the amount of intraoperative blood loss,the average number of surgeries,the length of hospital stays,the total hospitalization expense,the cure rate,the incidence of postoperative complications,the Hospital for Special Surgery Score(HSS)for postoperative knee function after surgery,and Kofoed score for postoperative ankle function score were recorded for two groups.Postoperative ankle function score(Kofoed score).After collection data of two groups,statistical analysis was performed and analysis results were compared.Results:The differences between the two groups in general information were not statistically significant(P>0.05).The antibiotic bone cement implantation group after focus curettage was superior to the bone transport group in the operation time,intraoperative blood loss and total hospitalization cost,and the differences were statistically significant(P<0.05).The bone transport group was superior to the antibiotic bone cement implantation group after focus curettage in the cure rate,clinical bone healing time,and complete weight bearing time,and the differences were statistically significant(P<0.05).The preoperative knee HSS score,ankle Koford score and SF-36 score of the two groups were different,but the difference not statistically significant(P>0.05);the bone transport group was better than the antibiotic bone cement implantation group after focus curettage in the last knee HSS score,ankle Koford score and SF-36 score,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion: Curettage and filling with antibiotic bone cement is relatively simple in operation.However,bone transport is superior to curettage and filling with antibiotic bone cement in patients' surgical outcome and postoperative recovery of joint function.