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KMID : 1094020160330050300
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Journal of Veterinary Clinics
2016 Volume.33 No. 5 p.300 ~ p.303
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One-Stage Treatment of Chronic Calcaneal Osteomyelitis with Bone Morphogenetic Protein 2 and Local Antibiotic Delivery in a Cat
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Kim Hyung-kyoo
Jeong Hee-Jun
Park Ji-Young
Jeong Seong-Mok
Lee Hae-Beom
Park Chul
So Kyung-Min
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Abstract
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An age-unknown, 4.8 kg, male, wild, domestic short-hair cat was presented for left hindlimb lameness. Aphysical examination revealed a draining tract which was suspected of bite on left calcaneal bone. The left tarsal jointwas markedly swollen and exudates were observed around the draining tract. Sequestrum at left calcaneus bone, andosteolysis were identified by radiography. The sequestrum and its surrounding exudative tissue were debrided duringsurgery and the tissue was submitted for bacterial culture and sensitivity test. The debridement caused a bone defect(1.5 cm × 0.5 cm × 0.5 cm) on the medial left calcaneal bone. Plate and screw fixation was performed to the calcaneusbone as buttress plate. Recombinant human bone morphogenetic protein-2 (rhBMP-2) loaded hydroxyapatite wasimplanted in the bone defect. Furthermore, Amikacin-impregnated collagen sponges were also placed around bone plateto deliver local antibiotics. A systemic antibiotic treatment regimen based on bacterial culture and sensitivity test resultswas administered for 4 weeks. The wound properly healed without any signs of infection, and the bone healing wasconfirmed by radiography. The patient showed normal weight bearing ambulation at 18 weeks after surgery. The useof rhBMP-2 and local antibiotic delivery system is a good surgical option for the one-stage treatment of chronicosteomyelitis.
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KEYWORD
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rhBMP-2, local antibiotic delivery system, chronic osteomyelitis, one-stage revisioin
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