OSTEOMYELITIS

Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376580/#:~:text=In%20a%20significantly%20larger%20series,and%2037%25%20within%205%20years

Disclaimer:

This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.
 

Image Credit: Johns Hopkins Medicine 

What is Osteomyelitis?

Our bones are the backbone of our existence. As the primary support structure of the body, our bone structure is often a part of our beings that we don’t think about unless there’s an underlying issue. Within the skeletal structure, it is possible to develop bacterial or fungal infections of the bones. This condition is classified as osteomyelitis and is a condition that affects about 2 out of every 10,000 people. 

Osteomyelitis is a condition that can worsen if left untreated, and during proliferation, bones can lose access to blood supply and ultimately result in bone tissue loss. As a rare, yet serious condition, it is possible that the bones can become infected via a multitude of ways including via the bloodstream, or more commonly via a medium such as an open fracture or a surgical procedure. 

Who does Osteomyelitis affect?

Osteomyelitis can affect both adults and children, though it is often less severe in children. With children, the acute osteomyelitis they develop is actually easier to treat, and it will quickly heal. Children often experience this condition in their arms or legs. 

Adults can experience either chronic cases of osteomyelitis or acute ones. Adults with conditions such as diabetes, compromised immune systems, or vascular conditions are more susceptible to osteomyelitis. The regions most affected in adults include the feet, the pelvis or the vertebrae of the spine. 

A comprehensive list of conditions that can induce osteomyelitis is highlighted below [2]:

What causes Osteomyelitis?

Osteomyelitis is a condition that is induced by a variety of microbial agents in the environment. The most prevalent inducer of osteomyelitis is found to be staphylococcus aureus. 

Osteomyelitis inducing conditions include: 

  • Open fractures that can result in infection of the skin and ultimately the bones. When a fracture results in bone protrusion, it does affect the odds of developing osteomyelitis.
  •  If a blood clot develops around a bone due to minor trauma, a secondary infection can result during the healing process. This condition can then induce an infection into the bones.
  • If there is bacteria in the bloodstream, it can actually become deposited onto the bones. If there is an accumulation of bacteria, the bone can become infected and degenerate. 

Symptoms of osteomyelitis

Osteomyelitis is a condition that has several symptoms that are experienced by patients. These include [1]: 

  • Pain, redness, tenderness and warmth sensations in the affected area. 
  • Swelling, redness and warmth in the infected area.
  • Fever.
  • Nausea, secondarily from being ill with infection.
  • General discomfort, uneasiness, or ill feeling.
  • Drainage of pus (thick yellow fluid) through the skin.
  • Excessive Sweating 
  • Chills 
  • Lower back pain for those who are affected in the spine
  • Changes in the gait

Osteomyelitis Treatment

Identification of the underlying osteomyelitis condition is the first step in medical treatment. An orthopaedic surgeon will usually include a detailed analysis of the patient. This analysis will include X-rays, blood tests and bone scans in order to identify what is truly happening in the internal state of the body. The critical test in ensuring that the treatment is customized to the patient is the bone biopsy. The bacterial count and identification can be determined by the test, and the orthopaedic specialist will then be able to prescribe the right medications to heal the bacterial accumulation. 

While the initial treatment will focus on antibiotic treatment, it is possible in some instances to actually have a surgical procedure that will facilitate healing of the bone. Surgery is administered as a medium to prevent amputation. Antibiotics are initially administered in an IV format for a few weeks, and then the patient is given a pill to heal the patient for the rest of the recovery time.

Preventing Osteomyelitis

Cleanliness is the key to the prevention of osteomyelitis. At best, ensure that you are washing wounds that are visible. Cover the wounds, and keep bandaged where possible. 

Chronic osteomyelitis is best treated with an orthopaedic specialist, who can control the condition.   Osteomyelitis, like all conditions, is better prevented than treated. It is a preventable condition, however there are special circumstances that can result in its development. Seeking appropriate medical care will take you on the road to recovery.

References: 

  1. Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/9495-osteomyelitis
  2. WebMD: https://www.webmd.com/diabetes/osteomyeltis-treatment-diagnosis-symptoms

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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