Treatment for osteomyelitis includes non-operative and operative techniques. Non-operative treatment includes administering antibodies to combat the infection. Antibiotic treatment requires knowledge on the type of bacteria causing the infection. This can be determined using a biopsy, a minimally invasive procedure that involves inserting a needle into the bone. A bone culture is obtained which can reveal the type of bacterial infection, which in turn will determine the appropriate antibody.
Surgical treatment may be necessary if the patient does not respond to antibiotic treatment. Other indications for surgery include chronic infections or the presence of significant necrotic (dead) bone.
The first step to surgery is to expose the infected bone and surrounding soft tissues and drain any fluid or pus that is present. The next step is to remove any infected bone and soft tissue, a process called debridement. The final step is to apply a bone graft. This will induce new bone to grow in place of the excised necrotic bone.
In cases where there is a large amount of necrotic bone, additional surgical treatment is necessary. When large amounts of bone are removed, this results in a bone defect. At the Paley Institute, we have treated many complicated bone defect cases through a technique known as bone transport. For more information on bone transport surgery, please see Treatment Strategies for Bone Defects.