Review Article

A Systematic Review and Meta-Analysis of Combined Antibiotic Spacer with Ilizarov Methods in the Treatment of Infected Nonunion of Tibia

Table 3

Interventions and outcomes of included studies.

Study no.The process of spacerBone results (Paley) (excellent/good/fair/poor)Functional results (Paley) (excellent/good/fair/poor)EFT (months)EFI (cm/d)Complications (per patient)Ingredients of spacer

1After RD, antibiotic cement beads were implanted. 2 weeks later, spacer is gradually removed during bone transport.22/7/2/01.7Cement mixed with sensitive antibiotics
2After RD, antibiotic cement was implanted. After 6 weeks, the spacer was removed before bone transport.8.50.61 (11/18)20 g cement mixed with 3-4 g vancomycin
3After RD, antibiotic spacers containing calcium sulfate were implanted and eventually absorbed naturally.11/1/0/060.44 (12/27)Solid containing calcium sulfate powder and vancomycin
4After RD, antibiotic cement beads were implanted. Spacer is gradually removed during bone transport.7/1/0/04.42.25 (18/8)20 g cement mixed with 0.25 g gentamicin and 3 g vancomycin
5After RD, antibiotic bone cement was implanted. After 4-7 weeks, the antibiotic cement was removed and induction membrane was sutured. The bone transport will begin after 7 days.13.248.51.43 (20/14)10 g cement mixed with 1 g vancomycin
6After RD, antibiotic bone cement was implanted. After 6 weeks, the antibiotic cement was removed and induced membrane was sutured. Besides, the bone transport began.8.556.60.5 (6/12)Antibiotic-impregnated cement
7After RD and bone grafting, the remaining defects were filled with bone cement containing gentamicin. After 1 week, the spacer was removed before bone transport.6/8/1/07.5Cement mixed with gentamicin
8After RD, antibiotic bone cement was implanted. After 7-10 days, spacer was gradually removed during bone transport.30/23/5/028/18/12/010.6360.67 (39/58)10 g cement mixed with 1.2 g tobramycin and 0.5 g vancomycin
9After RD, antibiotic bone cement was implanted. After 9 weeks, the spacer was removed and induced membrane was sutured. Besides, the bone transport began.18811.43 (10/7)40 g cement mixed with 0.5 g gentamicin or 2 g vancomycin
10After RD, implant antibiotic cement. The spacer was removed, and the Ilizarov method was used until no bacteria were found in all bacterial cultures of tissue samples. The spacer was removed, and the Ilizarov methods were performed.21.7571.4 (35/25)Antibiotic-impregnated cement
11After RD, antibiotic cement beads were implanted. After 3 weeks, the spacer was removed before performing Ilizarov methods.90.3 (3/10)2 g gentamicin in a bag of bone cement

Abbreviations: RD: radical debridement; EFT: external fixation index; EFI: external fixation index.