Providing a patient-friendly approach using CERAMENT®G – 10 years on at Oxford

For most patients suffering bone infections, the path to cure can be long-standing and complex even with the latest advances in medicine. Outcomes from surgery have a significant impact on their quality of life and livelihood. Attempting single-stage procedures to manage bone infection has been ongoing in the past decades to minimize the burden on patients and hospitals.

With patient-centered commitment, a team approach, and an eye for innovation, the Bone Infection Unit at Oxford University Hospital embarked on this journey to transform their practice.

"It is now ten years since we began our experience with CERAMENT G at the Oxford Bone Infection Unit. Initially we hoped it would be a small improvement over our previous treatments but it has become clear that it offers major benefits. We have used CERAMENT G in over 900 cases, including fracture-related infections, osteomyelitis, and foot infections,” recounts Professor Martin McNally of Oxford University Hospital.

The team at Oxford developed a single-stage protocol for management of bone infection, called ‘The Oxford Protocol’¹. Having CERAMENT G with Gentamicin integrated in the protocol has allowed for a single-stage approach as bone healing and local antibiotic elution is provided effectively in one device.

Last year, the Oxford team published mid- to long-term data of CERAMENT G in the Oxford Protocol, confirming its clinical effectiveness sustained over a long time period. Results at a mean follow-up of 6.05 years [range: 4.2 to 8.4 years] were reported from a prospective cohort of 100 patients where:

·   94% of patients remained infection-free

·   3% fracture rate and no further pathologic fractures beyond the first year after surgery

It was an outstanding result from using an orthobiologic device, “We have seen a significant reduction in our failure rate, very few complications and a much more patient-friendly, single stage treatment. Since the introduction of CERAMENT G to our protocol, we rarely need to bone graft bone defects and less than 2% of our cases require a staged approach for eradication of infection,” cites Professor McNally.

The impact of their journey extends well beyond Oxford. The unit is a well-known CERAMENT visitation center where the Oxford team shares best practices using CERAMENT with other surgical teams. Over the last 10 years, hundreds of surgeons, and surgical staff from across Europe have completed a visitation. Now with the arrival of CERAMENT G in the United States, the first US surgeons will be visiting in June this year.

“I would also like to record my appreciation of BONESUPPORT for ten years of commitment to education around the whole subject of musculoskeletal infection. This support has raised the profile of infection and focused many surgeons and physicians on the challenges ahead. I look forward to another ten years of fruitful collaboration for our patients," expresses Professor McNally.

References

1.     Mifsud, Max, and Martin McNally, ‘Local Delivery of Antimicrobials in the Treatment of Bone Infections’, Orthopaedics and Trauma, 33.3 (2019), 160–65 https://doi.org/10.1016/j.mporth.2019.03.007

 2.     McNally, M, et al., ‘Mid- to Long-Term Results of Single-Stage Surgery for Patients with Chronic Osteomyelitis Using a Bioabsorbable Gentamicin-Loaded Ceramic Carrier’, The Bone & Joint Journal, 104-B.9 (2022), 1095–1100 https://doi.org/10.1302/0301-620X.104B9.BJJ-2022-0396.R1