Do Antibiotic Beads Need to be Removed?

Document Type : RESEARCH PAPER


1 Hip and Knee Center at Northwest Primary and Specialty Care North Seattle, University of Washington, Seattle, WA, USA

2 Aurora Medical Center Summit Oconomowoc, WI, USA

3 Department of Orthopedic Surgery, Harborview Medical Center, University of Washington, Seattle, WA, USA


Background: Polymethylmethacrylate antibiotic impregnated beads can be an effective treatment for chronic
osteomyelitis or an adjuvant in the treatment of open fractures. It remains unclear however whether the beads cause
long-term adverse events if not removed. The purpose of this study was to determine if removal of antibiotic beads was
required in order to avoid long term complications.
Methods: A retrospective chart review was conducted on patients with an extremity or pelvis fracture that had
implantation of polymethylmethacrylate (PMMA) antibiotic beads over a five-year period.
Results: Fifty-one patients met inclusion criteria for this study; thirty-seven patients (73%) did not have complications
after surgical debridement and placement of PMMA antibiotic beads necessitating removal.
Conclusion: Our findings suggest that polymethylmethacrylate antibiotic beads can be utilized as a means of delivering
high-dose concentrations of local antibiotics and do not have to be removed in all patients.
Level of evidence: III


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