Abstract
Methicillin-resistant staphylococcus aureus (MRSA) infections have become a major therapeutic concern in the orthopaedic field. MRSA is resistant to most types of antibiotics, making it very difficult to treat. Between November 1995 and February 1998, MRSA infection of a joint or bone was found in 10 cases at our hospital. The mean age of the patients was 63 years, with age ranging from 13 to 91 years. The patients included 5 acute osteomyelitis, 2 chronic osteomyelitis and 3 pyogenic arthritis. 9 of these cases had been treated surgically. We treated 6 cases using closed continuous irrigation, another using the Papineau technique, and another using curettage at the focus. Another case of a 91-year-old man required amputation because of acute exacerbation of chronic osteomyelitis in the tibia. 7 cases were successfully treated, but 2 cases of an immunocompromised host showed recurrence and are still undergoing treatment. In our experience, we consider radical debridement, sequestrectomy and resection of scarred and infected bone and soft tissue to be the best therapeutic approach, while appropriate antibiotics therapy and/or closed continuous irrigation are also required.
