Tissue Guided Regeneration with Platelet Rich Plasma and Resorptive Collagen Membrane in Case of Chronic Osteomyelitis of Tibia

Background: Chronic osteomyelitis is a serious and difficult complication in open fractures, occurring in about 20% of cases. Treatment approach must be multidisciplinary with surgical basis. At the end of the classical eradication of the infection, there is often a large bone defect. Guided tissue regeneration (GTR) with allogeneic platelet gel, autologous cancellous bone graft and resorptive collagen membrane is one of the possibilities how to bridge bone defect. Patients: 26 year old male patient, suffered from chronic osteomyelitis. The therapy for osteomyelitis was started and after two months osteomyelitis was healed, soft tissue defect was grafted with surralis flap. GTR with allogeneic platelet gel and autologous cancellous bone graft and resorptive collagen membrane was performed to fill the defect. Results: The essential idea of this therapy was to combine the healing capacities of platelet-derived growth factors and osteogenic stem cells and the modeling capacity of the platelet gel. After 4 months of GTR therapy the graft was incorporated, the bone defect was fully bridged and full weight-bearing capacity was achieved. Using resorptive collagen membrane, healing capacities of tissue increased. Conclusions: The aim of our treatment approach, with GTR by allogeneic platelet gel, autologous and bone graft combined with collagen resorptive membrane can improve and shorten the treatment outcome.