Diagnostic and therapeutic aspects in patients with chronic osteomyelitis and prosthetic infections

Management of chronic osteomyelitis and prosthetic joint infections represents an emergent problem, despite the advances in antibiotics and new operative techniques. In order to evaluate the efficacy of a multidisciplinary approach we conducted a study on twelve patients with orthopedic devices related infections attending the Institute of Infectious Diseases of the University of Ferrara from 2001 to 2006, by analyzing clinical, laboratoristic and strumental outcomes.The best results were obtained for those patients who underwent surgical treatment, including bone debridement or removal of infected devices, associated with an adequate antibiotic treatment. Moreover, encouraging results were found by analyzing the outcomes from 2 patients who underwent hyperbaric (HBO) and antibiotic therapy, as well as in patients with prosthetic-joint infections treated with antibiotics only. Our experience allows us to confirm the importance of a close interaction between infectious disease specialists, orthopaedic surgeons, radiologists, plastic surgeons, microbiologists and specialists in hyperbaric medicine in the management of bone and prosthetic joint infections.