Combined debridement, bone graft and articular cavity sealing using synovium in treating metaphyseal osteomyelitis involving knee joints

Abstract

The aim of this study was to investigate the efficacy of combined debridement, bone graft and articular cavity sealing using synovium in the treatment of metaphyseal osteomyelitis involving the knee joint. Eleven patients with metaphyseal osteomyelitis, which involved femurs in 4 patients and tibiae in 7, were included. The patients received a novel treatment, which combined debridement, bone graft and articular cavity sealing using the synovium. Of the 11 patients, 4 patients with knee joint instability received a structural allograft and 7 with a stable knee joint underwent a particulate bone graft. The 11 patients underwent regular clinical and radiological evaluation; the average follow-up was 74 months (range, 58-96). Infection recurrence in the joint and bone graft area was not observed in 10 of the 11 cases. In one patient, who underwent a lateral granular cancellous bone allograft in the right tibial plateau, the infection recurred 2 weeks later in the graft area. The infection was arrested 3 months after re-debridement and a bilateral ilium bone graft to eliminate the dead space. Combined debridement, bone graft and articular cavity sealing using the synovium may be a feasible treatment for metaphyseal osteomyelitis involving the knee joint.