Comparison of the effect of medical calcium sulfate local bone graft and simple focus debridement for the treatment of joint tuberculosis / 中国综合临床

ABSTRACT

Objective To evaluate the clinical outcome of Osteoset artificial bone mixed Rifampicin for injection after radical debridement in the treatment of sacroiliac joint tuberculosis,and compare with debridement alone.Methods From May 2005 to August 2010,48 patients with sacroiliac joint tuberculosis patients underwent two different surgical methods were selected as analysis subjects in the Orthopedics Department of Chest Hospital of Hebei Province.Among them,27 cases underwent radical debridement and fusion with Osteoset artificial bone combined with Rifampicin for injection (Grafting group),and 21 case were treated with radical debridement only(Control group).The local wound healing,adverse reactions and regular imaging examination (pelvic X-ray and CT scan) were observed,and the surgical time,the intraoperative blood loss,postoperative 6 months and 12 months,18 months bone graft fusion rate,and Majeed scoring results of the patients were recorded and statistically analyzed.Results All patients were followed up from 20 to 30 months with an average of 24 months.There was no significant difference in terms of surgical time and operative bleeding between the two groups(P＞0.05).The rate of bone fusion in grafting group was 33.33％ (9/27) of 6 months after operation,88.9％(24/27) of 12 months after operation,and 96.3％ (26/27) of 18 months after operation.While that in control group was 4.76％ (1/21) of 6 months after operation,42.85 ％ (9/21) of 12 months after operation,and 42.85％ (9/21) of 18 months after operation.The differences of these parameters between the two groups were significant(x2 =5.85,20.92,15.90;P＜0.05).According to Majeed scoring system,the excellent and good rates were 100％ (27/27) in grafting group,76.19％ (16/21) in control group,the difference was statistically significant(x2=7.18 P＜0.05).Conclusion With Rifampicin loaded Osteoset artificial bone can recruit bone graft mass during the bone fusion for sacroiliac joint tuberculosis,and reduce the adverse reactions,achieve bone fusion earlier than the control group.