Treatment of chronic osteomyelitis using calcium hydroxyapatite ceramic implants impregnated with antibiotic.

We treated eighteen patients with chronic osteomyelitis by implanting pieces of antibiotic-impregnated calcium hydroxyapatite ceramic into a cavity produced after thorough surgical excision of necrotic tissue. Within three months the infected sites had all healed. During follow-up ranging from 24 to 75 months there was no recurrence of infection. Two of the patients had infected prosthetic joints which were successfully revised. Infection was controlled and incorporation of the ceramic material into host bone was demonstrated radiographically. We recommend the use of porous pieces of calcium hydroxyapatite impregnated with antibiotic as a new system for drug delivery in the treatment of chronic osteomyelitis.