Antibiotic coated rods: a 15-year experience of Indications, Surgical Techniques and Clinical Outcomes

Dr Andrew Foster, Principal Investigator: This project forms a part of my PhD at QUT and therefore encompasses coordinating all aspect of the project from design to publication; Professor Kevin Tetsworth, Principal Research Supervisor

Background/aims: Antibiotic coated rods (ACRs) composed of polymethyl methacrylate (PMMA) are used to osteomyelitis. This technique allows the application of local antibiotics while also providing a stable biomechanical environment to facilitate both infection eradication and bony union. Conway et al. have reported the largest case series to date, treating 110 patients in a single centre with a limb salvage rate of 100% for long bone osteomyelitis. Further data however is scarce, with the recent International Consensus Meeting on Musculoskeletal Infection giving a strong consensus that there is limited evidence regarding the indications and outcomes following the use of ACRs. The Royal Brisbane and Women’s Hospital (RBWH) has been using this technique over the past 15 years, which would represent the largest case series to date. Our aim is to describe the indications, surgical techniques and clinical outcomes following the use of an ACR.

Methodology: This study has been approved by the human research ethics committee of RBWH (HREC/2020/QRBW/60760). A 15-year retrospective case-series of patients managed at the RBWH will be performed, with patients identified using the Operating Room Management Information System (ORMIS). Data extraction from the medical records will be performed to identify all relevant demographical, clinical and outcome variables at 1 year post-operative. Clinical costings associated with this procedure will be obtained through the Health Funding and Insights unit . Data will be analysed using Graphpad Prism and p values less than 0.05 are considered statistically significant.

Grant Funding: Grant funding will be used for database/statistical assistance.

Timeline: Ethics and research governance- completed. Data collection- 80% complete. Database management, statistical analysis- July/2021 – January/2022.  Submitted for publication before June/2022.