The Classification of Long Bone Osteomyelitis: A Systemic Review of the Literature
<p class="p p-first" id="__p2"><strong>Background:</strong> Osteomyelitis is a complex disease. Treatment involves a combination of bone resection, antimicrobials and soft-tissue coverage. There is a difficulty in unifying a classification system for long bone o...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Copernicus Publications
2017-09-01
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| Series: | Journal of Bone and Joint Infection |
| Online Access: | https://jbji.copernicus.org/articles/2/167/2017/jbji-2-167-2017.pdf |
| _version_ | 1818577248199901184 |
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| author | A. J. Hotchen A. J. Hotchen M. A. McNally P. Sendi P. Sendi P. Sendi P. Sendi |
| author_facet | A. J. Hotchen A. J. Hotchen M. A. McNally P. Sendi P. Sendi P. Sendi P. Sendi |
| author_sort | A. J. Hotchen |
| collection | DOAJ |
| description | <p class="p p-first" id="__p2"><strong>Background:</strong> Osteomyelitis is a complex disease. Treatment involves a combination of bone resection, antimicrobials and soft-tissue coverage. There is a difficulty in unifying a classification system for long bone osteomyelitis that is generally accepted.</p><p id="__p3"><strong>Objectives:</strong> In this systematic review, we aim to investigate the classification systems for long bone osteomyelitis that have been presented within the literature. By doing this, we hope to elucidate the important variables that are required when classifying osteomyelitis.</p><p id="__p4"><strong>Methods:</strong> A complete search of the Medline, EMBASE, Cochrane and Ovid databases was undertaken. Following exclusion criteria, 13 classification systems for long-bone osteomyelitis were included for review.</p><p id="__p5"><strong>Results:</strong> The 13 classification systems that were included for review presented seven different variables that were used for classification. Ten of them used only one main variable, two used two variables and one used seven variables. The variables included bone involvement (used in 7 classification systems), acute versus chronic infection (used in 6), aetiopathogenesis (used in 3), host status (used in 3), soft tissue (used in 2), microbiology (used in 1) and location of infected bone (used in 1). The purpose of each classification system could be grouped as either descriptive (3 classification systems), prognostic (4) or for management (4). Two of the 13 classification systems were for both prognostic and management purposes.</p><p class="p p-last" id="__p6"><strong>Conclusions:</strong> This systematic review has demonstrated a variety of variables used for classification of long bone osteomyelitis. While some variables are used to guide management and rehabilitation after surgery (e.g., bone defect, soft tissue coverage), others were postulated to provide prognostic information (e.g., host status). Finally, some variables were used for descriptive purposes only (aetiopathogenesis). In our view and from today's perspective, bone involvement, antimicrobial resistance patterns of causative micro-organisms, the need for soft-tissue coverage and host status are important variables to include in a classification system.</p> |
| first_indexed | 2024-12-16T06:26:53Z |
| format | Article |
| id | doaj.art-144607fa800f4eacb339cb77b6cb5eec |
| institution | Directory Open Access Journal |
| issn | 2206-3552 |
| language | English |
| last_indexed | 2024-12-16T06:26:53Z |
| publishDate | 2017-09-01 |
| publisher | Copernicus Publications |
| record_format | Article |
| series | Journal of Bone and Joint Infection |
| spelling | doaj.art-144607fa800f4eacb339cb77b6cb5eec2022-12-21T22:40:58ZengCopernicus PublicationsJournal of Bone and Joint Infection2206-35522017-09-01216717410.7150/jbji.21050The Classification of Long Bone Osteomyelitis: A Systemic Review of the LiteratureA. J. Hotchen0A. J. Hotchen1M. A. McNally2P. Sendi3P. Sendi4P. Sendi5P. Sendi6Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK;Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK;Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK;Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK;Institute for Infectious Diseases, University of Bern, Bern, Switzerland;Department of Infectious Diseases, Bern University Hospital, Bern, Switzerland;Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland.<p class="p p-first" id="__p2"><strong>Background:</strong> Osteomyelitis is a complex disease. Treatment involves a combination of bone resection, antimicrobials and soft-tissue coverage. There is a difficulty in unifying a classification system for long bone osteomyelitis that is generally accepted.</p><p id="__p3"><strong>Objectives:</strong> In this systematic review, we aim to investigate the classification systems for long bone osteomyelitis that have been presented within the literature. By doing this, we hope to elucidate the important variables that are required when classifying osteomyelitis.</p><p id="__p4"><strong>Methods:</strong> A complete search of the Medline, EMBASE, Cochrane and Ovid databases was undertaken. Following exclusion criteria, 13 classification systems for long-bone osteomyelitis were included for review.</p><p id="__p5"><strong>Results:</strong> The 13 classification systems that were included for review presented seven different variables that were used for classification. Ten of them used only one main variable, two used two variables and one used seven variables. The variables included bone involvement (used in 7 classification systems), acute versus chronic infection (used in 6), aetiopathogenesis (used in 3), host status (used in 3), soft tissue (used in 2), microbiology (used in 1) and location of infected bone (used in 1). The purpose of each classification system could be grouped as either descriptive (3 classification systems), prognostic (4) or for management (4). Two of the 13 classification systems were for both prognostic and management purposes.</p><p class="p p-last" id="__p6"><strong>Conclusions:</strong> This systematic review has demonstrated a variety of variables used for classification of long bone osteomyelitis. While some variables are used to guide management and rehabilitation after surgery (e.g., bone defect, soft tissue coverage), others were postulated to provide prognostic information (e.g., host status). Finally, some variables were used for descriptive purposes only (aetiopathogenesis). In our view and from today's perspective, bone involvement, antimicrobial resistance patterns of causative micro-organisms, the need for soft-tissue coverage and host status are important variables to include in a classification system.</p>https://jbji.copernicus.org/articles/2/167/2017/jbji-2-167-2017.pdf |
| spellingShingle | A. J. Hotchen A. J. Hotchen M. A. McNally P. Sendi P. Sendi P. Sendi P. Sendi The Classification of Long Bone Osteomyelitis: A Systemic Review of the Literature Journal of Bone and Joint Infection |
| title | The Classification of Long Bone Osteomyelitis: A Systemic Review of the Literature |
| title_full | The Classification of Long Bone Osteomyelitis: A Systemic Review of the Literature |
| title_fullStr | The Classification of Long Bone Osteomyelitis: A Systemic Review of the Literature |
| title_full_unstemmed | The Classification of Long Bone Osteomyelitis: A Systemic Review of the Literature |
| title_short | The Classification of Long Bone Osteomyelitis: A Systemic Review of the Literature |
| title_sort | classification of long bone osteomyelitis a systemic review of the literature |
| url | https://jbji.copernicus.org/articles/2/167/2017/jbji-2-167-2017.pdf |
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