A BIPHASIC BONE SUBSTITUTE WITH GENTAMYCIN REGENERATES BONE IN OSTEOMYELITIS WITH MUSCLE ACTING AS AN OSTEOINDUCTIVE NICHE

To demonstrate the role of an antibiotic containing bone substitute, native bone active proteins and muscle transforming into bone.Recurrent osteomyelitis was eradicated and filled with a gentamycin eluting bone substitute (Cerament™l G) consisting of sulphate and apatite phases and covered by a muscle flap.C2C12 muscle cells were seeded on the bone substitute in-vitro and their phenotype was studied.Another muscle cell line L6 was seeded with osteoblast conditioned medium containing bone active proteins and specific markers were studied for bone differentiation.A chronic, longstanding, fistulating osteomyelitis was operated with radical eradication and filling of the cavity with gentamycin eluting bone substitute. At one year, the patient had no leg pain and a healed wound. Significant bone was also seen in the overlaying muscle, at one month post-op disappearing after 6-months. Local delivery of gentamycin had a protective effect on bone formation.C2C12 cells seeded on the gentamycin eluting bone substi...