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International Orthopaedics

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12-11-2022 | Wound Debridement | Original Paper

Localization of osteomyelitis lesions for operative eradication of chronic osteomyelitis of the lower extremities by bone SPECT/CT: a feasibility study

Authors: Seung Hoo Lee, Min Bom Kim

Published in: International Orthopaedics | Issue 1/2023

Abstract

Purpose

This study was performed to investigate the feasibility of bone single-photon emission tomography/computed tomography (SPECT/CT) for pre-operative planning of chronic osteomyelitis (COM) of the lower extremities by localization of osteomyelitis lesions.

Methods

From January 2016 to January 2020, we surgically treated ten adult patients with Cierny-Mader type III COM in the tibia or femur for a mean duration of 24.4 months (range 7.0–70.0 months). We conducted pre-operative planning by bone SPECT/CT and localization of osteomyelitis lesions. The treatment consisted of intra-operative eradication of the infective focus and antibiotic administration. The clinical and radiological outcomes were retrospectively analyzed after a minimum of one year of follow-up.

Results

The patients were surgically treated by thorough debridement, dead space management, and appropriate antibiotics without bone transport or an external fixator. The location of the hot uptake region on bone SPECT/CT coincided with that of the osteomyelitis lesion, which was confirmed intra-operatively in all patients. At an average of 16.5 ± 4.3 months (range, 13.0–25.0 months), clinical eradication of osteomyelitis was achieved in nine of the ten patients. One patient required amputation due to recurrence of osteomyelitis. A successful clinical outcome was achieved in eight patients; one suffered persistent ankle pain due to a destructive change in the ankle joint despite eradication of the infection.

Conclusion

Bone SPECT/CT is a feasible method for the localization and eradication of osteomyelitis lesions in COM of the lower extremities and has favourable clinical outcomes. It can also be applied in cases of distorted bony structures caused by previous trauma or surgery, or in the presence of implants.

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Title: Localization of osteomyelitis lesions for operative eradication of chronic osteomyelitis of the lower extremities by bone SPECT/CT: a feasibility study
Authors: Seung Hoo Lee
Min Bom Kim
Publication date: 12-11-2022
Publisher: Springer Berlin Heidelberg
Keywords: Wound Debridement
Bone Infection
Antibiotic
Osteomyelitis
Published in: International Orthopaedics / Issue 1/2023
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-022-05617-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Localization of osteomyelitis lesions for operative eradication of chronic osteomyelitis of the lower extremities by bone SPECT/CT: a feasibility study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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