Erminia Bentivegna, Luigi Donato, Concetta Scimone, Vivaldi Roberto, Mularo Salvatore, Citarrella Emanuele, Mavaro Giuseppe, Rosalia D’Angelo, Antonina Sidoti
Implant of devices in patients affected by serious osteoporosis following chronical inflammatory diseases like rheumatoid arthritis represent a great clinic and surgical challenge, especially when associated with bacterial infections. Here we report a case of a 75 years old woman who developed recidivism of infection, after prosthesis’ implantation. Although repeated treatments with both topical antibiotics and systemic ones, knee edema and purulent secretion were constant.Conventional treatment based on topical and systemic antibiotics’ administration was replaced with a vascular rehabilitative medical therapy. Furthermore, the patient has undergone surgery for ulcers and fistulas debridement at the knee, the lower third of thigh and the upper third of leg. The analyzed case suggested that the experimental protocol we used to treat implant – derived osteomyelitis with cutaneous fistulization could reduce the healing time between the primary lesion and osteomyelitis complication, but only if patient presents an acceptable condition of his immune system.
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