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Antibiotic-loaded porous hydroxyapatite blocks for the treatment of osteomyelitis and postoperative infection. A preliminary report.

Hydroxyapatite blocks (HAB) can be used to administer antibiotics or anticancer drugs because its porous structure allows the gradual administration of the pharmacologic agents. A novel drug delivery system using hydroxyapatite blocks was developed for osteomyelitis and postoperative infections occurring after joint replacement. To load the antibiotics, hydroxyapatite blocks were mixed with an antibiotic solution and centrifuged at 1500 rpm for 15 minutes or decompressed in vacuum container at 5 to 10 in. Hg for 20 minutes. Fifteen patients with osteomyelitis including one with tuberculosis and four with infections subsequent to joint replacement were treated with antibiotic-loaded hydroxyapatite blocks in combination with intravenous injection. Except in one case, all of the foci had completely healed at follow-up (range: 13 to 71 months; average: 39.7 months). These new methods are simple and can safely treat osteomyelitis in a one-stage operation.