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Infection Control / Chronic Disease · Journal article
Annals of Medicine · June 9, 2026
Encouraging direction, but not yet definitive.
This retrospective cohort study of 244 chronic osteomyelitis patients demonstrates that vancomycin-loaded PMMA combined with vancomycin sulfate calcium (PMMA-SC) was associated with superior infection control, lower reoperation rates, and reduced systemic inflammation compared to PMMA alone. The combination therapy showed statistically significant benefits across clinical efficacy, inflammatory markers, and complication rates, suggesting PMMA-SC may represent a more effective local antibiotic delivery strategy.
Retrospective cohort with 244 patients over 7 years. Adults aged 18 years or older with chronic post-traumatic or postoperative osteomyelitis lasting more than six weeks with vancomycin-sensitive bacterial cultures.
Infection control rate was significantly higher with PMMA-SC versus PMMA alone (87.29% vs. 72.22%, p = 0.004) Reoperation rate was significantly lower with PMMA-SC versus PMMA (7.63% vs. 21.43%, p = 0.002) Overall complication rate was significantly lower in PMMA-SC group (8.47% vs. 26.19%, p < 0.001)
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
The combination of vancomycin sulfate calcium with PMMA appears to offer clinically meaningful advantages over PMMA alone, with absolute risk reductions of approximately 15% for infection control and 14% for reoperations. Multivariate analysis identified PMMA-SC as a significant protective factor for treatment success, supporting its consideration as a therapeutic option for chronic osteomyelitis management.
Retrospective cohort of 244 patients shows statistically significant improvements in infection control and reoperation rates favoring combination therapy, though observational design limits causal inference.
As stated by the source record.
Quoted from the source exactly as published.
The combination of vancomycin sulfate calcium with PMMA appears to offer clinically meaningful advantages over PMMA alone, with absolute risk reductions of approximately 15% for infection control and 14% for reoperations. Multivariate analysis identified PMMA-SC as a significant protective factor for treatment success, supporting its consideration as a therapeutic option for chronic osteomyelitis management.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Purpose. This study aimed to compare the impact on inflammatory response, clinical efficacy, and safety between vancomycin-loaded polymethylmethacrylate (PMMA) and a combination of vancomycin-loaded PMMA with vancomycin sulfate calcium (PMMA-SC) in treating chronic osteomyelitis.Methods. A retrospective cohort study involved 244 patients with chronic osteomyelitis treated between January 2017 and December 2024. Patients were divided into PMMA (n = 126) and PMMA-SC (n = 118) groups. Postoperative outcomes, efficacy, inflammatory markers, quality of life, and complications were evaluated.Results. The PMMA-SC group demonstrated significantly higher rates of infection control (87.29% vs. 72.22%, p = 0.004) and lower reoperation rates (7.63% vs. 21.43%, p = 0.002) compared to the PMMA group. The PMMA-SC intervention was associated with a more robust attenuation of systemic inflammation, evidenced by significantly greater reductions in neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and procalcitonin (PCT) (all p < 0.05). Quality of life measures, particularly physical functioning, general health, and vitality, also favored the PMMA-SC group (p < 0.05). The overall complication rate was significantly lower in the PMMA-SC group (8.47% vs. 26.19%, p < 0.001). The multivariate logistic regression analysis demonstrated that PMMA-SC was a significant protective factor for treatment success (p < 0.05).Conclusion. The combination of vancomycin sulfate calcium with PMMA was associated with improved outcomes compared to PMMA alone, potentially attributable to its association with enhanced control of infection and a more favorable modulation of the systemic inflammatory and immune response. These findings support its consideration as a promising therapeutic strategy for chronic osteomyelitis.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.