Treatment of infected tibial non-unions using a BMAC and S53P4 BAG combination for reconstruction of segmental bone defects: A clinical case series

IntroductionTreatment of infected non-unions the tibia is a challenging problem. The cornerstones optimal non-union treatment consist extensive debridement, fracture fixation, antimicrobial therapy and creation an local biological bone healing environment. combination S53P4 bioactive glass (BAG), as osteostimulative antibacterial graft substitute, marrow aspirate concentrate (BMAC) for implantation mesenchymal stem cells growth factors might be promising combination. In this paper, preliminary results new algorithm presented.MethodsIn retrospective case series patients with are treated according to algorithm. Patients debridement surgery, replacement osteosynthesis BAG BMAC in one-stage or two-stage procedure based on severity. Subsequently culture antibiotic followed until union infection eradication.ResultsFive were treated, mean age was 55, average NUSS-score 44 segmental defect 4.6cm. One patient four induced membrane-, “Masquelet”-procedure. On average, 23 ml 6.2 implanted. follow-up period 13.6 months at end all had clinical consolidation RUST-score 7.8 complete eradication infection.DiscussionThese early data combined shows results. These rates resulted functional recovery patients. To substantiate these results, larger higher quality studies should performed.