(CS-046) Revolutionary Flowable Gentamicin: Calcaneal Osteomyelitis Does Not Need to End in Below Knee Amputation

Introduction: Osteomyelitis of the calcaneus is a leading cause of below-knee amputations and requires urgent attention and intervention. A new product is making significant strides in transforming the treatment of osteomyelitis infections. Instead of resorting to radical debridement or below-knee amputation, a flowable gentamicin antibiotic-based bone graft* is being successfully injected to treat these infections. In this study, we aim to demonstrate that healing can be achieved even in complex cases.

Methods: This case series involved five diabetic patients with multiple comorbidities and heel ulcers complicated by osteomyelitis. All underwent surgery with an injection of gentamicin-based flowable bone graft*. After the procedure, patients were monitored in an outpatient setting with regular dressing changes, and imaging studies were conducted at various stages: before surgery, during, and at healing. Some patients received multiple injections throughout their treatment.

Results: The study aims to evaluate whether bone injections of antibiotics could serve as an effective curative treatment for osteomyelitis. All five patients demonstrated resolution of their osteomyelitis and returned to full weight-bearing status upon healing. Notably, three of these patients were initially offered amputation as their first-line treatment option.

Discussion: It is crucial that we explore new approaches to treating osteomyelitis. By employing this innovative surgical technique, we successfully prevented amputation in five patients with difficult-to-heal calcaneal osteomyelitis. This is a promising new approach that warrants further research.