Osteomyelitis treated with gentamicin-PMMA beads - 100 patients followed for 1-12 years

We treated 100 patients having osteomyelitis with debridement and gentamici n-PMMA beads and followed them for 5 (1-12) years. 66 of the infections wer e chronic, in 18 cases combined with arthritis and in 3 cases with pseudart hrosis. They underwent 117 "treatment periods", consisting of one or more o perations (total 152), in most cases with an interval of 2 weeks. No system ic antibiotics were necessary besides the local antibiotic treatment in 52 of the treatment periods. Healing was achieved in 92 patients, in 78 after a single treatment period which included 7-5 operations, in 14 after two or three treatment periods. Healing was more difficult to achieve when the in fection was chronic, especially with a duration of more than 6 years or whe n caused by elective surgery. Local antibiotic treatment with gentamicin PM MA beads has the advantage that the wound can be closed primarily and that a higher local antibiotic concentration in the tissues can be achieved, oft en making systemic antibiotic treatment unnecessary.